Capacity Balancing Algorithm for Placement of Observation Patients: Assessing the Effect on ED Crowding

Abstract

Software initiatives that collect, store, and share substance use disorder (SUD) patient data experience significant barriers, including additional patient privacy and confidentiality requirements beyond HIPAA. This paper reports on a design science research effort aimed at managing peer support and clinician interactions with individuals with SUD and sharing their pertinent information with emergency rooms (ERs). Privacy and confidentiality challenges are presented along with the resulting system design that was implemented in the state of Alabama. A usability and security survey was administered to system end users (n=18) to assess information security perceptions. Findings suggest respondents were satisfied with the system, while several users felt that the system was unnecessarily complex due to MFA and auto-log off features. Specific confidentiality considerations and logic mechanisms should be designed into the application functionality at the project outset to facilitate transitions of care benefits for SUD patients.