scholarly journals Barriers and facilitators to a health information exchange system for general practitioners

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N S Centemero ◽  
B Rechel

Abstract Background Health information exchange (HIE) systems, that are computer-based tools used by healthcare providers for secure access to share patient's medical information electronically, seem to help reduce the use of specific resources and improve the quality of care. This highlights the importance of this issue in the Public Health sector. This research goal is to identify barriers and facilitators perceived by general practitioners (GPs) when using an HIE system in a Southern Switzerland area. Methods we performed a qualitative study using semi-structured interviews, interviewed 10 GPs, randomly selected among some 500 HIE system local users and analysed interview transcripts using thematic content analysis with an abductive approach (a mix of deductive and inductive approaches). Results findings showed the following key facilitators: a) perception of dealing with a secure system; b) possibility of delegating management to secretaries and healthcare assistants; c) technical support and training; d) high quality of the information exchange; e) positive impact on clinical practice; and f) regional context. However, major challenges persist, and GPs reported the following main barriers to using an HIE system: a) frequent lack of all patient information needed; b) no effective workflow improvements; c) lack of some technical features. Conclusions We propose four recommendations based on findings: 1. Future initiatives should focus on developing HIE systems giving GPs access to all possible patient medical information; 2. Crucial data privacy and security issues should never be overlooked; 3. Technical and workflow improvements should particularly consider the socio-technical nature of HIE systems; 4. Much attention needs to be paid to the importance of relationships between health care providers and between these and local health institutions when implementing HIE systems. Key messages This study filled a research gap as it is the first that tackles HIE system barriers and facilitators in Ticino. When information sharing for clinical practice focuses on improving the quality and costs of healthcare, GP's trust in HIE system security is crucial.

Author(s):  
Alice Noblin ◽  
Kendall Cortelyou-Ward

Since 2004, the services of the Florida Health Information Exchange (HIE) have grown, and in 2011, the state contracted with Harris Corporation to provide some basic services to the Florida health care industry and provide functional improvements to the expanding state-wide HIE. The endeavors of this public-private partnership continue to the present day; however, as HIE services have expanded, challenges continue to be encountered. Ultimately, successful exchange of medical data requires patient engagement and “buy-in.” The purpose of this article will consider why patient engagement is important for HIE success, offer recommendations to improve both patient and provider interest, and consider the importance of online patient portals to increase the effectiveness of health record keeping and the sharing of vital patient medical information needed by caregivers and their patients.


2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Rogier van de Wetering

Modern hospitals increasingly make use of innovations and information technology (IT) to improve workflow and patient’s clinical journey. Typical innovative solutions include patient records and clinical decision support systems to enhance the process of decision making by doctors and other healthcare practitioners. However, currently, it remains unclear how hospitals could facilitate and enable such a decision support capability in clinical practice. We ground our work on the resource-based view of the firm and put forth the notion of IT-enabled capabilities which emphasizes critical IT investment and capability development areas that hospitals could exploit in their quest to improve clinical decision support. We develop a research model that explains how “health information exchange” and enhanced “information capability” collectively drive a hospital’s “clinical decision support capability.” We used partial least squares path modeling on large-scale cross-sectional data from 720 European hospitals. Outcomes suggest that health information exchange positively impacts information capability. In turn, information capability complementary partially mediates the relationship between information exchange and clinical decision support. Hence, this research contributes to the literature on clinical decision support and provides valuable insights into how to support such innovative technologies and capabilities in clinical practice. We conclude with a discussion and conclusion. Also, we outline the inherent limitations of this study and outline directions for future research.


2007 ◽  
Vol 31 (4) ◽  
pp. 531 ◽  
Author(s):  
Peter Sprivulis ◽  
Jan Walker ◽  
Douglas Johnston ◽  
Eric Pan ◽  
Julia Adler-Milstein ◽  
...  

Objective: To estimate costs and benefits for Australia of implementing health information exchange interoperability among health care providers and other health care stakeholders. Design: A cost?benefit model considering four levels of interoperability (Level 1, paper based; Level 2, machine transportable; Level 3, machine readable; and Level 4, machine interpretable) was developed for Government-funded health services, then validated by expert review. Results: Roll-out costs for Level 3 and Level 4 interoperability were projected to be $21.5 billion and $14.2 billion, respectively, and steady-state costs, $1470 million and $933 million per annum, respectively. Level 3 interoperability would achieve steadystate savings of $1820 million, and Level 4 interoperability, $2990 million, comprising transactions of: laboratory $1180 million (39%); other providers, $893 million (30%); imaging centre, $680 million (23%); pharmacy, $213 million (7%) and public health, $27 million (1%). Net steady-state Level 4 benefits are projected to be $2050 million: $1710 million more than Level 3 benefits of $348 million, reflecting reduced interface costs for Level 4 interoperability due to standardisation of the semantic content of Level 4 messages. Conclusions: Benefits to both providers and society will accrue from the implementation of interoperability. Standards are needed for the semantic content of clinical messages, in addition to message exchange standards, for the full benefits of interoperability to be realised. An Australian Government policy position supporting such standards is recommended.


JAMIA Open ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Sue S Feldman ◽  
Grishma P Bhavsar ◽  
Benjamin L Schooley

AbstractObjectivesThe objective of this article is to examine consumer perceptions of health information technology (health IT) utilization and benefits through an integrated conceptual framework.Materials and MethodsThis article employs an integrated conceptual framework to examine consumer perceptions of health IT. A consumer survey yielded 1125 completed responses. A factor-based scale was developed for each sub-construct. Bivariate analysis using χ2 tests was performed to determine differences in the percentage of respondents who agreed with each sub-construct based on whether their physician used an electronic health record (EHR) system. Multivariable logistic regression that controlled for demographic characteristics of respondents was performed to determine adjusted odds of agreeing with selected opinions of health information exchange (HIE).ResultsResults indicate that respondents whose physicians used an EHR system were significantly more likely to agree that there was a perceived benefit with HIE and to care provided; that the patient should have control over the record; that they trust the physician and security of the medical information; that they understand the need for HIE, and that HIE must be easy to use.DiscussionThe results suggest that consumers who have experienced the use of one technology in the healthcare setting can recognize the potential benefit of another technology. Race/ethnicity, gender, and education played some role in respondents’ views of EHRs and HIE, more specifically, non-Hispanic African American participants indicated lower levels of trust in HIE when compared with non-Hispanic Whites.ConclusionThis cross-sectional survey indicated that physician use of EHRs significantly increases the odds of consumers’ seeing perceived benefits of HIE and understanding the need for HIE.


Author(s):  
Gerald Beuchelt ◽  
Harry Sleeper ◽  
Andrew Gregorowicz ◽  
Robert Dingwell

Health data interoperability issues limit the expected benefits of Electronic Health Record (EHR) systems. Ideally, the medical history of a patient is recorded in a set of digital continuity of care documents which are securely available to the patient and their care providers on demand. The history of electronic health data standards includes multiple standards organizations, differing goals, and ongoing efforts to reconcile the various specifications. Existing standards define a format that is too complex for exchanging health data effectively. We propose hData, a simple XML-based framework to describe health information. hData addresses the complexities of the current HL7 Clinical Document Architecture (CDA). hData is an XML design that can be completely validated by modern XML editors and is explicitly designed for extensibility to address future health information exchange needs. hData applies established best practices for XML document architectures to the health domain, thereby facilitating interoperability, increasing software developer productivity, and thus reducing the cost for creating and maintaining EHR technologies.


2012 ◽  
Vol 28 (2) ◽  
pp. 176-183 ◽  
Author(s):  
James E. Bailey ◽  
Jim Y. Wan ◽  
Lisa M. Mabry ◽  
Stephen H. Landy ◽  
Rebecca A. Pope ◽  
...  

2019 ◽  
Vol 77 (4) ◽  
pp. 299-311 ◽  
Author(s):  
Claudia Guerrazzi

The sharing of information among various care providers is becoming an essential feature of health care systems, and many countries are now adopting policies to foster health information exchange, defined as the electronic transfer of data or information among health care organizations involved in the delivery of care. Given the increasing adoption of this type of policy in several Organization for Economic Cooperation and Development countries, it is important to compare experiences from different countries, because policy adoption in one country can be explained more comprehensively and coherently through comparison with similar policies adopted in other nations. To make a more meaningful cross-country comparison, this article identifies a taxonomy of health systems, and it analyzes institutional and resource-based factors related to health information exchange adoption and how they differ in three main types of health systems: the National Health Service, social health insurance, and private health insurance.


2021 ◽  
Vol 12 (03) ◽  
pp. 564-572
Author(s):  
Masaharu Nakayama ◽  
Ryusuke Inoue ◽  
Satoshi Miyata ◽  
Hiroaki Shimizu

Abstract Background Health information exchange (HIE) may improve diagnostic accuracy, treatment efficacy, and safety by providing treating physicians with expert advice. However, most previous studies on HIE have been observational in nature. Objectives To examine whether collaboration between specialists and general practitioners (GPs) in rural areas via HIE can improve outcomes among patients at low-to-moderate risk of cardiovascular disease, kidney disease, and stroke. Methods In this randomized controlled trial, the Miyagi Medical and Welfare Information Network was used for HIE. We evaluated the clinical data of 1,092 patients aged ≥65 years living in the rural areas of the Miyagi Prefecture and receiving care from GPs only. High-risk patients were immediately referred to specialists, whereas low-to-moderate risk patients were randomly assigned to an intervention group in which GPs were advised by specialists through HIE (n = 518, 38% male, mean age = 76 ± 7 years) or a control group in which GPs received no advice by specialists (n = 521, 39% male, mean age = 75 ± 7 years). Results In the intention-to-treat analysis, all-cause mortality and cumulative incidence of serious adverse events (e.g., hospital admission or unexpected referral to specialists) did not differ between the groups. However, per-protocol analysis controlling for GP adherence with specialist recommendations revealed significantly reduced all-cause mortality (p = 0.04) and cumulative serious adverse event incidence (p = 0.04) in the intervention group compared with the control group. Conclusion HIE systems may improve outcomes among low-to-moderate risk patients by promoting greater collaboration between specialists and GPs, particularly in rural areas with few local specialists.


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