Approaches to Patient Health Information Exchange and Their Impact on Emergency Medicine

Shapiro, Jason S.; Kannry, Joseph L.; Lipton, Mark; Goldberg, Eric; Conocenti, Paul; Stuard, Susan S; Wyatt, Brian M; Kuperman, Gilad J.

doi:10.1016/j.annemergmed.2006.03.032

Cited by 89 publications

(66 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the successful adoption of health information exchanges (HIE), the following issues need to be addressed: data availability, data standards, technical architecture, finances, privacy, and public health and research (Shapiro et al, 2006). In addition, Kern et al (2009) reported that financial sustainability, technical architecture, and practice transformation were necessary for interoperable health information technology.…”

Section: Health Information Exchangesmentioning

confidence: 99%

“…The 1999 Institute of Medicine report, To Err is Human, identified fragmented health systems as a major cause of errors because providers cannot access patient data (Shapiro et al, 2006). Health care providers need the ability to access timely patient data when the data are needed (Shapiro et al, 2006) since patient safety is dependent on the right information available to the right person at the right time (Kaelber & Bates, 2007).…”

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

“…HIEs have the potential to impact ED workflow efficiency by decreasing redundant testing and throughput times, reducing unnecessary admissions and the number of admitted patients waiting for beds, and decreasing the number of patients waiting to be seen or leaving the ED without being seen (Shapiro et al, 2006). However, a database study of 4,830 U.S. hospitals reported that adoption and implementation of HIEs are different phenomena with many non-technological factors a barrier to an effective HIE, such as increased ED volume or competition between healthcare organizations (Vest, 2010).…”

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

“…Health care providers need the ability to access timely patient data when the data are needed (Shapiro et al, 2006) since patient safety is dependent on the right information available to the right person at the right time (Kaelber & Bates, 2007). Because patients use the ED for urgent and unplanned visits, the right information at the time of the patient visit is not always available and emergency physicians order treatment without understanding the patient's complete medical history (Hripcsak, Sengupta, Wilcox, & Green, 2007).…”

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

“…The Mount Sinai Medical Center ED in New York City improved patient flow by redesigning workflows and implementing a fully integrated ED information system with direct access to historical patient data in a hospital repository (Baumlin et al, 2010). The Indiana Network for Patient Care compiled information over a four year period from 19 facilities and 12 EDs that demonstrated a substantial portion of healthcare is delivered through emergency visits (50% of the Indianapolis population) and therefore, the hospital information infrastructure is an important component of the HIE (Finnell et al, 2005).HIEs have the potential to impact ED workflow efficiency by decreasing redundant testing and throughput times, reducing unnecessary admissions and the number of admitted patients waiting for beds, and decreasing the number of patients waiting to be seen or leaving the ED without being seen (Shapiro et al, 2006). However, a database study of 4,830 U.S. hospitals reported that adoption and implementation of HIEs are different phenomena with many non-technological factors a barrier to an effective HIE, such as increased ED volume or competition between healthcare organizations (Vest, 2010).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Emergency Physicians' Perspectives on the Usability of Health Information Exchange

Thorn¹

View full text Add to dashboard Cite

Emergency physicians are key users of health information exchanges (HIE).Understanding their perspectives on the usability of HIE is important if the full potential of the HIE is to be achieved. The literature identified that emergency physician experiences with HIEs are unexplored areas requiring further studies. The purpose of this study using grounded theory methods was to understand the perspectives of emergency physicians concerning the usability of HIEs. The fundamental question was how do emergency physicians use the HIE in making clinical decisions?Rich and thick data were collected from 15 emergency physicians in four urban hospitals in the mid-south using theoretical sampling and unstructured face-to face interviews. Concepts from the coded segments were developed into categories and an overarching theoretical scheme visualized in a conceptual framework. A substantive theory emerged that using the HIE among emergency physicians is the process of rationalizing non-use and reconciling challenges and benefits. The antecedent of usability was a typical day in the emergency department and why participants accessed the HIE and under what conditions. Six major themes emerged: using the HIE, influencing clinical decisions, struggling with challenges and barriers, recognizing benefits, current views, and rationalizing not using or reduced-use of the HIE.Emergency physicians gave good reasons why the HIE is not being used for the majority of patients while reconciling the challenges and benefits of using the HIE to explain the role of HIEs in making clinical decisions. There was a disconnect in the necessity of using the HIE to make clinical decisions and any negative outcomes that may occur in patients from not using the HIE. Generally, emergency physicians viewed the HIE as not being user-friendly and that they probably do not use the HIE as much as they could for making clinical decisions. The perspective of the emergency physicians was the emergency environment is too busy and because the HIE is less than user-friendly as needed by physicians to practice emergency medicine, the HIE disrupts workflow and is a deterrent to consistent usage in making clinical decisions.A better understanding of how emergency physicians decided to use the HIE in making clinical decisions gives insights about how to achieve HIE usability. Satisfied end-users who view the HIE as effective and efficient should use the HIE more. However, this requires removing challenges and barriers while recognizing more benefits to using the HIE, and addressing the underlying reasons for not using the HIE. Understanding the complexities of using the HIE and providing solutions to increase usability of the HIE is necessary to influence greater use of the HIE in clinical decisions with demonstrated positive outcomes for patients.v Medicine, 2006). A nationwide health information network (NHIN) providing health information exchange (HIE) brings patient health data to the point of care, which according to an Institute of Medicine (IOM) Comm...

show abstract

Section: Health Information Exchangesmentioning

confidence: 99%

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

Section: Communication Between Providers (The Joint Commission On Accmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Emergency Physicians' Perspectives on the Usability of Health Information Exchange

Thorn¹

View full text Add to dashboard Cite

show abstract

Developing Pediatric Data Standards

Rosenbloom

Kuhl

2009

Health Informatics

View full text Add to dashboard Cite

Public Health Informatics and Health Information Exchange

Magnuson

2013

Health Informatics

View full text Add to dashboard Cite

Approaches to Patient Health Information Exchange and Their Impact on Emergency Medicine

Cited by 89 publications

References 14 publications

Emergency Physicians' Perspectives on the Usability of Health Information Exchange

Emergency Physicians' Perspectives on the Usability of Health Information Exchange

Developing Pediatric Data Standards

Public Health Informatics and Health Information Exchange

Contact Info

Product

Resources

About