The United Hospital Fund meeting on evaluating health information exchange

Hripcsak, George; Kaushal, Rainu; Johnson, Kevin B.; Ash, Joan S.; Bates, David W.; Block, Rachel I.; Frisse, Mark E.; Kern, Lisa M.; Marchibroda, Janet; Overhage, J. Marc; Wilcox, Adam B.

doi:10.1016/j.jbi.2007.08.002

Cited by 55 publications

(54 citation statements)

References 5 publications

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“…Hripcsak et al (40) Expert opinion (conference proceedings) This is a summary of a 2006 meeting where experts discussed how to evaluate HIEs and developed a series of ordered steps for the evaluation process, including (1) platform evaluation, (2) usage studies, (3) assessment of the immediate business case, (4) assessment of clinical and administrative impact, (5) unintended consequences, (6) comprehensive return on investment, and (7) program evaluation.…”

Section: Doebbeling Et Al (30)mentioning

confidence: 99%

Systematic Review of Health Information Exchange in Primary Care Practices

Fontaine¹,

Se²,

Zink³

et al. 2010

The Journal of the American Board of Family Medicine

175

153

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Background: Unprecedented federal interest and funding are focused on secure, standardized, electronic transfer of health information among health care organizations, termed health information exchange (HIE). The stated goals are improvements in health care quality, efficiency, and cost. Ambulatory primary care practices are essential to this process; however, the factors that motivate them to participate in HIE are not well studied, particularly among small practices.Methods: We conducted a systematic review of the literature about HIE participation from January 1990 through mid-September 2008 to identify peer-reviewed and non-peer-reviewed publications in bibliographic databases and websites. Reviewers abstracted each publication for predetermined key issues, including stakeholder participation in HIE, and the benefits, barriers, and overall value to primary care practices. We identified themes within each key issue, then grouped themes and identified supporting examples for analysis.Results: One hundred and sixteen peer-reviewed, non-peer-reviewed, and web publications were retrieved, and 61 met inclusion criteria. Of 39 peer-reviewed publications, one-half reported original research. Among themes of cost savings, workflow efficiency, and quality, the only benefits to be reliably documented were those regarding efficiency, including improved access to test results and other data from outside the practice and decreased staff time for handling referrals and claims processing. Barriers included cost, privacy and liability concerns, organizational characteristics, and technical barriers. A positive return on investment has not been documented. Conclusions:The potential for HIE to reduce costs and improve the quality of health care in ambulatory primary care practices is well recognized but needs further empiric substantiation. (J Am Board Fam Med 2010;23:655-670.)

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Section: Doebbeling Et Al (30)mentioning

confidence: 99%

Systematic Review of Health Information Exchange in Primary Care Practices

Fontaine¹,

Se²,

Zink³

et al. 2010

The Journal of the American Board of Family Medicine

175

153

View full text Add to dashboard Cite

show abstract

“…To develop survey questions for benefits and concerns, we first reviewed literature on the effects of an HIE and frameworks for quality evaluations of services in general, healthcare services, and information technology services. 22,[27][28][29] The finalized list of benefit domains were quality, time, cost, safety, and managerial aspects of providers. The concerns domain included information safety and security, system reliability, and managerial aspects of providers.…”

Section: Pre-implementation Surveymentioning

confidence: 99%

Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

Lee

Park

Kim³

et al. 2012

Telemedicine and e-Health

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Objective: We examined physicians' perceived needs, benefits, and concerns regarding health information exchange (HIE) technology prior to experiencing it and their actual usage of exchanged information in care processes during an HIE pilot program in South Korea. Materials and Methods: We conducted a survey through a structured questionnaire to collect data on physician perceptions about an HIE prior to implementation. We analyzed responses using descriptive statistics and one-way analyses of variance. We also conducted a post-implementation survey through a computerized tool designed to collect data on physician assessment of HIE item usefulness. We defined two indices to measure the volume of information flow and usefulness for individual HIE items and analyzed the indices with Fisher's exact test. Results: Physicians' overall perceptions about the need for an HIE and benefits of the technology were positive despite their concerns about information safety and security, system costs, and disputes between care providers in cases of malpractice. We found that physician practice settings significantly influenced the details of their perceptions. In the both pre-and post-implementation studies, the most needed and valued information were pathology and lab results, diagnostic imaging, medication, and working diagnosis. Physicians most agreed with the benefit potentials in the quality domain, least agreed with those in time and cost savings of healthcare delivery, and least worried about the decrease in revenues resulting from the technology. Conclusions: The overall physician acceptance of the HIE technology in South Korea is promising, but the adoption and diffusion strategy needs to be tailored to the type of physician practice. Concerted efforts may be needed to realize the much-anticipated potential of healthcare cost savings.

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“…Electronic health information exchange (HIE), by improving provider access to patient information and enhancing care coordination, may reduce hospital readmissions. 9 HIE systems electronically share identified, patient-level information with providers and organizations across the continuum of care. This information sharing enables clinical personnel point-of-care access to patient data about recent encounters that occurred at other points-of-care, such as discharge summaries, prescribed medications, laboratory tests, imaging studies, and other information.…”

Section: Introductionmentioning

confidence: 99%

The potential for community-based health information exchange systems to reduce hospital readmissions

Vest

Kern

Silver

et al. 2014

Journal of the American Medical Informatics Association

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Background Hospital readmissions are common, costly, and offer opportunities for utilization reduction. Electronic health information exchange (HIE) systems may help prevent readmissions by improving access to clinical data by ambulatory providers after discharge from the hospital. Objective We sought to determine the association between HIE system usage and 30-day same-cause hospital readmissions among patients who consented and participated in an operational community-wide HIE during a 6-month period in 2009–2010. Methods We identified a retrospective cohort of hospital readmissions among adult patients in the Rochester, New York area. We analyzed claims files from two health plans that insure more than 60% of the area population. To be included in the dataset, patients needed to be continuously enrolled in the health plan with at least one encounter with a participating provider in the 6 months following consent to be included in the HIE system. Each patient appeared in the dataset only once and each discharge could be followed for at least 30 days. Results We found that accessing patient information in the HIE system in the 30 days after discharge was associated with a 57% lower adjusted odds of readmission (OR 0.43; 95% CI 0.27 to 0.70). The estimated annual savings in the sample from averted readmissions associated with HIE usage was $605 000. Conclusions These findings indicate that usage of an electronic HIE system in the ambulatory setting within 30 days after hospital discharge may effectively prevent hospital readmissions, thereby supporting the need for ongoing HIE efforts.

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The United Hospital Fund meeting on evaluating health information exchange

Cited by 55 publications

References 5 publications

Systematic Review of Health Information Exchange in Primary Care Practices

Systematic Review of Health Information Exchange in Primary Care Practices

Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

The potential for community-based health information exchange systems to reduce hospital readmissions

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