An “integrated health neighbourhood” framework to optimise the use of EHR data

Abstract

General practice should become the hub of integrated health neighbourhoods (IHNs), which involves sharing of information to ensure that medical homes are also part of learning organisations that use electronic health record (EHR) data for care, decision making, teaching and learning, quality improvement and research.The IHN is defined as the primary and ambulatory care services in a locality that relates largely to a single hospital-based secondary care service provider and is the logical denominator and unit of comparison for the optimal use of EHR data and health information exchange (HIE) to facilitate integration and coordination of care. Its size may vary based on the geography and requirements of the population, for example between city, suburban and rural areas.The conceptual framework includes context; integration of data, information and knowledge; integration of clinical workflow and practice; and inter-professional integration to ensure coordinated shared care to deliver safe and effective services that are equitable, accessible and culturally respectful.We illustrate how this HIE-supported IHN vision may be achieved with an Australian case study demonstrating the integration of linked pseudonymised records with knowledge-and evidence-based guidelines using semantic web tools and informatics-based methods, researching causal links bewteen data quality and quality of care and the key issues to address.

Digital Health Data Quality Issues: Systematic Review

“…Multiple definitions of DQ were discussed in the literature (Multimedia Appendix 5 [17,18,[20][21][22]31,54,[67][68][69][70][71][72][73][74][75][76][77]). There was no consensus on a single definition of DQ; however, an analysis of the definitions revealed two perspectives, which we labeled as the (1) context-agnostic perspective and (2) context-aware perspective.…”

UK National Data Guardian for Health and Care’s Review of Data Security: Trust, better security and opt-outs

“…It is left to local initiatives to try to link well-defined geographical neighbourhood to provide insights into clinical indicators and health services use in the context of integrated care 30. Much more needs to be done around the custodianship and stewardship of repositories of EHR data 31…”