scholarly journals An empirical analysis of the financial benefits of health information exchange in emergency departments

2015 ◽  
Vol 22 (6) ◽  
pp. 1169-1172 ◽  
Author(s):  
Niam Yaraghi
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Laboratory Tests ◽  
Negative Binomial ◽  
Health Information Exchange ◽  
Negative Binomial Regression ◽  
Control Group ◽  
History Of ◽  
The Impact

Abstract Objective To examine the impact of health information exchange (HIE) on reducing laboratory tests and radiology examinations performed in an emergency department (ED). Materials and Methods The study was conducted in an ED setting in Western New York over a period of 2 months. The care of the patients in the treatment group included an HIE query for every encounter, while the care of other patients in the control group did not include such queries. A group of medical liaisons were hired to query the medical history of patients from an HIE and provide it to the ED clinicians. Negative binomial regression was used to analyze the effects of HIE queries on the number of performed laboratory tests and radiology examinations. The log files of the HIE system since 1 year before the ED admission were used to analyze the differences in outcome measures between the 2 groups of patients. Results Ceteris paribus, HIE usage is associated with, respectively, 52% and 36% reduction in the expected total number of laboratory tests and radiology examinations ordered per patient at the ED. Conclusions The results indicate that access to additional clinical data through the HIE will significantly reduce the number of laboratory tests and radiology examinations performed in the ED settings and thus support the ongoing HIE efforts.

scholarly journals The benefits of health information exchange: an updated systematic review

2018 ◽  
Vol 25 (9) ◽  
pp. 1259-1265 ◽  
Author(s):  
Nir Menachemi ◽  
Saurabh Rahurkar ◽  
Christopher A Harle ◽  
Joshua R Vest
Keyword(s):  
Systematic Review ◽  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Care Delivery ◽  
The United States ◽  
Current Systematic Review ◽  
Meta Analyses ◽  
The Impact

Abstract Objective Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Results Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. Conclusions The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

scholarly journals Exploring the role of the Care and Health Information Exchange (CHIE) in clinical decision-making: a realist evaluation

2020 ◽  
Author(s):  
Philip Scott ◽  
Elisavet Andrikopoulou ◽  
Haythem Nakkas ◽  
Paul Roderick
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Social Care ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Health And Social Care ◽  
The Impact

Background: The overall evidence for the impact of electronic information systems on cost, quality and safety of healthcare remains contested. Whilst it seems intuitively obvious that having more data about a patient will improve care, the mechanisms by which information availability is translated into better decision-making are not well understood. Furthermore, there is the risk of data overload creating a negative outcome. There are situations where a key information summary can be more useful than a rich record. The Care and Health Information Exchange (CHIE) is a shared electronic health record for Hampshire and the Isle of Wight that combines key information from hospital, general practice, community care and social services. Its purpose is to provide clinical and care professionals with complete, accurate and up-to-date information when caring for patients. CHIE is used by GP out-of-hours services, acute hospital doctors, ambulance service, GPs and others in caring for patients. Research questions: The fundamental question was How does awareness of CHIE or usage of CHIE affect clinical decision-making? The secondary questions were What are the latent benefits of CHIE in frontline NHS operations? and What is the potential of CHIE to have an impact on major NHS cost pressures? The NHS funders decided to focus on acute medical inpatient admissions as the initial scope, given the high costs associated with hospital stays and the patient complexities (and therefore information requirements) often associated with unscheduled admissions. Methods: Semi-structured interviews with healthcare professionals to explore their experience about the utility of CHIE in their clinical scenario, whether and how it has affected their decision-making practices and the barriers and facilitators for their use of CHIE. The Framework Method was used for qualitative analysis, supported by the software tool Atlas.ti. Results: 21 healthcare professionals were interviewed. Three main functions were identified as useful: extensive medication prescribing history, information sharing between primary, secondary and social care and access to laboratory test results. We inferred two positive cognitive mechanisms: knowledge confidence and collaboration assurance, and three negative ones: consent anxiety, search anxiety and data mistrust. Conclusions: CHIE gives clinicians the bigger picture to understand the patient's health and social care history and circumstances so as to make confident and informed decisions. CHIE is very beneficial for medicines reconciliation on admission, especially for patients that are unable to speak or act for themselves or who cannot remember their precise medication or allergies. We found no clear evidence that CHIE has a significant impact on admission or discharge decisions. We propose the use of recommender systems to help clinicians navigate such large volumes of patient data, which will only grow as additional data is collected.

hData - A Simple XML Framework for Health Data Exchange

2009 ◽  
Author(s):  
Gerald Beuchelt ◽  
Harry Sleeper ◽  
Andrew Gregorowicz ◽  
Robert Dingwell
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Care Providers ◽  
Future Health ◽  
Data Interoperability ◽  
History Of ◽  
Electronic Health

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.

Health Information Exchange between Specialists and General Practitioners Benefits Rural Patients

2021 ◽  
Vol 12 (03) ◽  
pp. 564-572
Author(s):  
Masaharu Nakayama ◽  
Ryusuke Inoue ◽  
Satoshi Miyata ◽  
Hiroaki Shimizu
Keyword(s):  
Health Information ◽  
General Practitioners ◽  
Rural Areas ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Intervention Group ◽  
Control Group ◽  
Moderate Risk ◽  
All Cause Mortality ◽  
Risk Patients

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.

scholarly journals Evaluation of a health information exchange system for microcephaly case-finding — New York City, 2013—2015

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237392
Author(s):  
Eugenie Poirot ◽  
Carrie W. Mills ◽  
Andrew D. Fair ◽  
Krishika A. Graham ◽  
Emily Martinez ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Health Information ◽  
York City ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Case Finding ◽  
Exchange System

scholarly journals Drivers of information disclosure on health information exchange platforms: insights from an exploratory empirical study

2015 ◽  
Vol 22 (6) ◽  
pp. 1183-1186 ◽  
Author(s):  
Niam Yaraghi ◽  
Raj Sharman ◽  
Ram Gopal ◽  
Ranjit Singh ◽  
R Ramesh
Keyword(s):  
Primary Care ◽  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Information Disclosure ◽  
Primary Care Physicians ◽  
Medical Information ◽  
Health Information Exchange ◽  
Care Physician ◽  
Willingness To Disclose

Abstract Objective The objective of this research is to empirically explore the drivers of patients’ consent to sharing of their medical records on health information exchange (HIE) platforms. Materials and Methods The authors analyze a dataset consisting of consent choices of 20 076 patients in Western New York. A logistic regression is applied to empirically investigate the effects of patients’ age, gender, complexity of medical conditions, and the role of primary care physicians on patients’ willingness to disclose medical information on HIE platforms. Results The likelihood of providing consent increases by age (odds ratio (OR) = 1.055; P  < .0001). Female patients are more likely to provide consent (OR = 1.460; P  = .0003). As the number of different physicians involved in the care of the patient increases, the odds of providing consent slightly increases (OR = 1.024; P  = .0031). The odds of providing consent is significantly higher for the patients whom a primary care physician has been involved in their medical care (OR = 1.323; P  < .0001). Conclusion Individual-level characteristics are important predictors of patients’ willingness to disclose their medical information on HIE platforms.

scholarly journals Identifying homelessness using health information exchange data

2015 ◽  
Vol 22 (3) ◽  
pp. 682-687 ◽  
Author(s):  
John Zech ◽  
Gregg Husk ◽  
Thomas Moore ◽  
Gilad J Kuperman ◽  
Jason S Shapiro
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Housing Status ◽  
Number Of Patients ◽  
Address Data ◽  
Patients Experience ◽  
Exchange Data

Abstract Background Homeless patients experience poor health outcomes and consume a disproportionate amount of health care resources compared with domiciled patients. There is increasing interest in the federal government in providing care coordination for homeless patients, which will require a systematic way of identifying these individuals. Objective We analyzed address data from Healthix, a New York City–based health information exchange, to identify patterns that could indicate homelessness. Methods Patients were categorized as likely to be homeless if they registered with the address of a hospital, homeless shelter, place of worship, or an address containing a keyword synonymous with “homelessness.” Results We identified 78 460 out of 7 854 927 Healthix patients (1%) as likely to have been homeless over the study period of September 30, 2008 to July 19, 2013. We found that registration practices for these patients varied widely across sites. Conclusions The use of health information exchange data enabled us to identify a large number of patients likely to be homeless and to observe the wide variation in registration practices for homeless patients within and across sites. Consideration of these results may suggest a way to improve the quality of record matching for homeless patients. Validation of these results is necessary to confirm the homeless status of identified individuals. Ultimately, creating a standardized and structured field to record a patient’s housing status may be a preferable approach.

scholarly journals Big Data and Smart Health Strategies: Findings from the Health Information Systems Perspective

2014 ◽  
Vol 23 (01) ◽  
pp. 125-127 ◽  
Author(s):  
M. Cuggia ◽  
L. Toubiana ◽  
Keyword(s):  
Information Technology ◽  
Big Data ◽  
Information Systems ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Information Systems ◽  
Systems Perspective ◽  
Smart Health ◽  
The Impact

Summary Objectives: To summarize excellent current research in the field of Health Information Systems. Method: Creation of a synopsis of the articles selected for the 2014 edition of the IMIA Yearbook. Results: Four papers from international peer reviewed journals were selected and are summarized. Conclusions: Selected articles illustrate current research regarding the impact and the evaluation of health information technology and the latest developments in health information exchange.

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