Home Health Data bridge ‘built out of binder-twine and hope’ integrates primary care and public health

Data bridge ‘built out of binder-twine and hope’ integrates primary care and public health

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January 31, 2023

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In Alberta, Canada, stakeholders built a data bridge between independent primary care providers and public health officials to share information on SARS-CoV-2 test results and ultimately to help the community respond to the pandemic. Improved base support.

According to researchers, these efforts Chronicles of Family Medicine, It provides insights for other jurisdictions considering strategies to integrate primary care and public health.

Miles Leslie, PhD, MJ, MA, Assistant Professor and Associate Dean of Research in the School of Public Policy at the University of Calgary and colleagues say primary care is critical in supporting public health initiatives, providing community care, including vaccination, and alleviating the undue burden of emergencies. I wrote that it played a central role. Acute care facilities to maintain health system resilience, but “the experience of integration into pandemic response is poorly understood.”

“With a view to achieving universal health care and sustainable development, the World Health Organization has stressed the importance of integrating primary care into the broader health system,” the researchers wrote. “Integration into primary care We aim to bring together a diverse group of individuals and professionals to provide care for people with complex health needs while eliminating service overlaps and gaps. “

In a situation where testing and treatment delivery responsibilities are shared, Leslie said, “It’s important that test results flow seamlessly into primary care.”

To learn more about how the data bridge was built, Leslie and colleagues conducted 57 semi-structured, qualitative interviews with public health and primary care stakeholders within the Calgary Health Zone. .

Researchers found that SARS-CoV-2 test results from local public laboratories were initially available to central public health clinicians, but not to independent primary care providers. .

“While this enabled centralized contact tracing, primary care physicians were unaware of patients’ COVID-19 status and were unable to provide follow-up care within the community. ‘, they wrote.

However, stakeholders have leveraged “policy commitments to the Patient Medical Home (PMH) model of care, various existing organizational structures, and governance arrangements to create a data bridge that bridges the gap.”

According to Leslie, PMH (called PMH in the US) PCMH), “We aim to connect patients to a coherent team of primary health care professionals who work together to ensure that access is not just available, but on a patient’s condition.”

“Primary health care teams are focused on treating the whole person (not just the disease) over the long term, through prevention and a variety of non-medical interventions such as physical therapy, mental health counseling and mental health counseling. , trying to help patients manage their health, such as nutrition counseling.”

Leslie further explained that PMH paved the way for data bridges. [what would become] bridge. “

“PMH’s core tenets of patient focus, ensuring access, and using technology to manage people’s health provide a lens for people in primary care to see problems and imagine solutions. was,” he said.

This model of care and other integration-focused policy mandates are part of the foundation upon which the data bridge was built, the researchers wrote. Others were organizational structures that brought stakeholders together to work on integrated projects, and “governance arrangements that create relationships and spaces in which improvisation can occur.”

According to Leslie, the data bridge will be from a spreadsheet containing SARS-CoV-2 test results from central laboratories, which public health officials “hand-card”, to an automated, direct link from central laboratories to primary care providers. It states that it has changed to an encoded data path. .

“The data bridge for this article was initially built out of binders and hopes, but over time various stakeholders have been able to contribute real resources and the power of information technology,” says Leslie. says Mr. “Whether patients tested positive or negative for COVID-19, test results that had simply been placed in databases in central laboratories or flooded public health departments with nowhere to go were ultimately They had a destination, they were making sure patients were routed to sick doctors to provide care and management advice in the community.”

The researchers found that without a well-established functional interface between the central health system and primary care, both routine primary care integration efforts and the pandemic response are likely to be compromised. I wrote. But it has a silver lining.

“Working to build a data bridge and give primary healthcare teams access to test data is not only possible, it is achievable,” says Leslie.

For primary care systems seeking to learn from building data bridges, Leslie and colleagues bring together primary and non-primary care stakeholders to work on common projects and work on ‘care leveraging’ organizations and governance structures. I wrote that I may consider a method. Model your commitment to integration. “

“Such policies and structures build trust, open up the possibilities for champions to emerge, and create a space in which integrative improvisation takes place,” they concluded.

In the accompanying editorial, trisha greenhalf, OBE, FRCP, FRCGP, FMedSci, A professor of primary health care at the University of Oxford wrote that the study “shows how the vital role of primary care has been overlooked in the heat of emergency response”.

“Like most of us [family doctors] As we discovered in early 2020, it is difficult to provide holistic care to individuals and proactive advice to families and communities in a rapidly changing pandemic.


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