RESUMO
The foundational role of health information exchanges (HIEs) is to facilitate communication between clinical partners in real time. Once this infrastructure for the secure and immediate flow of patient information is built, however, HIEs can benefit community public health and clinical care in myriad other ways that are in line with their mission, goals, patient privacy, and funding structures. We encourage the development of community-integrated HIEs and list specific steps that can be taken toward community integration. We give three examples of those steps in action from a community HIE in El Paso, TX. Each local partnership, in combination with technology innovation, resulted in the development of informatics tools to address community health needs and generated long-term benefits, especially for the most vulnerable patients. Two examples relate to different aspects of the COVID-19 pandemic and a third to the Afghan refugee evacuation.
Assuntos
COVID-19 , Troca de Informação em Saúde , Humanos , Texas , Pandemias , ConfidencialidadeRESUMO
Upper limb paresis is a major source of disability in stroke survivors, and robotic aided exercise therapy is a promising approach to enhance motor abilities. Few devices have been available to provide robotic therapy to the fingers and hand. We report an open-label pilot study of 12 individuals with chronic moderate hemiparesis after stroke who underwent a six-week training program using a hand robotic device. Participants received a total of 18 hours of robotic therapy. Improvements were found in multiple measures of motor performance, including the Upper Extremity Fugl-Meyer, the Motor Activity Log, the Manual Ability Measure-36, and the Jebsen Hand Function Test. All subjects tolerated the treatment well and no complications were observed. We conclude that robotic therapy for hand paresis after stroke is safe and feasible, and that further studies of efficacy are justified by these preliminary results.
