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通过目录管理改进直接安全消息传递
Kristian Feterik1, Katherine Lusk2, Kathryn Ayers Wickenhauser3
1Department of Biomedical Informatics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States.
Applied clinical informatics
|October 24, 2025
概括
标准化直接安全消息 (DSM) 地址目录管理改善了健康信息交换. 实施最佳实践减少了无法交付的消息,增加了新的Direct地址,提高了互操作性.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健互操作性 医疗保健互操作性
- 数字健康传播数字健康传播
背景情况:
- 直接安全消息 (DSM) 对于医疗保健数据交换至关重要,但由于不完整的地址目录而受到阻碍.
- 缺乏标准化的目录管理工作流程,阻碍了对健康信息的及时和普遍访问.
- 德克萨斯州卫生服务管理局 (THSA) 确定迫切需要改善DSM地址目录实践.
研究的目的:
- 开发维护DSM地址目录的最佳实践.
- 为增加德克萨斯州DSM技术的采用创造建议.
- 为全国范围的DSM优化制定一个模型政策.
主要方法:
- 一个工作组由THSA成立,专注于增加DSM的采用.
- 从2021年8月到2022年3月,工作组成员使用了经过修改的Delphi过程.
- 在实施政策之前和之后,THSA监控了38家医院的消息量.
主要成果:
- 一个DSM地址目录管理最佳实践政策于2022年5月发表.
- 由于未知地址而未发送的消息在2021年9月至2022年12月期间从50%降至42%.
- 参与组织报告说,从2021年7月到2024年3月,新发行的Direct地址每月稳步增加.
结论:
- 医疗机构必须标准化DSM地址数据,并与外部数据库同步,以实现无消息流.
- 在从业者状态发生变化时,对目录条目立即更新至关重要.
- 美国国家安全局的政策为优化DSM作为全国关键互操作性标准提供了一个模型.
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