Linking the health data system in the U.S.:Challenges to the benefits

连接美国健康数据系统:挑战到裨益

In order to improve patient care in the United States there,the government made a mandate called HIE(Health Information Exchange).This order was created from the belief that sharing digital health in-formation between,across,and within health communities will improve one's healthcare experience across their lifespan.Patient health information,i.e.the personal health record,should be shareable between healthcare providers;such as private practice physicians,home health agencies,hospitals and nursing care facilities.Most of the U.S.hospitals now have electronic health records,however,with a lack of standards for structuring health information and unified communication protocols to share health information across providers,only a small percentage of U.S.hospitals engage in computerized HIE.In order to understand barriers and facilitators in the U.S.of HIE adoption,we reviewed the published research literature between 2010 and 2015.Our search yielded 664 articles from Medline,PsychInfo,Global health,InSpec,Scopus and Business Source Complete databases.Thirty-nine articles met our inclusion criteria.This article presents the compiled organizational and end user barriers and facilitators along with suggested methods to achieve continuity of care through HIE.

为了改善美国的医疗护理质量,美国政府要求进行健康信息交流(health information exchange,HIE)。此要求源于在健康社区间共享数字健康信息能提升人群在整个生命周期中医疗保健体验的信念。患者健康信息,如个人健康记录,应在譬如私人执业医师、家庭卫生机构、医院和护理机构的医务人员间共享。虽然大部分美国医院现已拥有电子健康记录,但由于缺乏构建卫生信息和统一通信协议的标准来共享健康信息,只有一小部分美国医院参与了计算机化的HIE。为了解美国实施HIE的障碍和促进因素,我们回顾了2010年至2015年间发表的文献。从Medline,PsychInfo,Global health,InSpec,Scopus和Business Source Com-plete的数据库中共检索出664篇文章,其中39篇符合纳入标准。本文总结了医疗机构和终端用户实施HIE的障碍和促进因素,并提出如何通过HIE实现连续性医疗照顾的建议。