scholarly journals Which veterans enroll in a VA health information exchange program?

2016 ◽  
Vol 24 (1) ◽  
pp. 96-105 ◽  
Author(s):  
Brian E Dixon ◽  
Susan Ofner ◽  
Susan M Perkins ◽  
Laura J Myers ◽  
Marc B Rosenman ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Medical Center ◽  
Care Utilization ◽  
Veterans Health ◽  
Health Administration ◽  
Multivariable Logistic Regression Model ◽  
Electronic Health ◽  
Definition Of Success

Objective: To characterize patients who voluntarily enrolled in an electronic health information exchange (HIE) program designed to share data between Veterans Health Administration (VHA) and non-VHA institutions. Materials and Methods: Patients who agreed to participate in the HIE program were compared to those who did not. Patient characteristics associated with HIE enrollment were examined using a multivariable logistic regression model. Variables selected for inclusion were guided by a health care utilization model adapted to explain HIE enrollment. Data about patients’ sociodemographics (age, gender), comorbidity (Charlson index score), utilization (primary and specialty care visits), and access (distance to VHA medical center, insurance, VHA benefits) were obtained from VHA and HIE electronic health records. Results: Among 57 072 patients, 6627 (12%) enrolled in the HIE program during its first year. The likelihood of HIE enrollment increased among patients ages 50–64, of female gender, with higher comorbidity, and with increasing utilization. Living in a rural area and being unmarried were associated with decreased likelihood of enrollment. Discussion and Conclusion: Enrollment in HIE is complex, with several factors involved in a patient’s decision to enroll. To broaden HIE participation, populations less likely to enroll should be targeted with tailored recruitment and educational strategies. Moreover, inclusion of special populations, such as patients with higher comorbidity or high utilizers, may help refine the definition of success with respect to HIE implementation.

scholarly journals Implementing health information exchange: Perceptions of leaders within the Veterans Health Administration (Preprint)

2020 ◽  
Author(s):  
Cherie Luckhurst ◽  
Brian E Dixon ◽  
David Haggstrom
Keyword(s):  
Health Information ◽  
Medical Staff ◽  
Information Exchange ◽  
Health Informatics ◽  
Success Factors ◽  
Health Information Exchange ◽  
Care Delivery ◽  
Electronic Record ◽  
Veterans Health ◽  
Health Administration

BACKGROUND The U.S. Department of Veterans Affairs (VA) seeks to achieve interoperability with other organizations, including other integrated delivery networks, via its Virtual Lifetime Electronic Record (VLER) program. OBJECTIVE While prior research has examined the adoption and use of VA health information exchange (HIE) among providers, this study sought to understand the implementation of VA-HIE by a wider range of organizational leaders. METHODS Operational, clinical, and health informatics leaders at the VA facility and its external community HIE partner were interviewed. Respondents discussed their experiences with HIE including barriers and facilitators to implementation. Qualitative analyses utilized a hybrid method that combined inductive and deductive approaches. RESULTS VA leaders considered training and preparation to be key success factors when implementing HIE and employed a wide array of strategies to prepare medical staff. During recruitment, a “high-touch approach” was successfully used to enlist patients in-person. Operational and clinical leaders described at least two potential barriers to HIE use: (1) the time and effort to use the system and (2) a fear of disappointment among medical staff and leadership. Overall enthusiasm was consistently high regarding the potential value of data sharing in improving care coordination and patient health outcomes. CONCLUSIONS The major management challenge was coordination of the complex interrelationships among entities within and outside the VA. A model that captures the interconnected web of information systems and human teams is helpful to visualize and describe HIE implementation. This model can be applied by other national and regional networks that seek to achieve interoperability goals across health care delivery systems. CLINICALTRIAL n/a

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

2013 ◽  
Vol 32 (8) ◽  
pp. 1346-1354 ◽  
Author(s):  
Michael F. Furukawa ◽  
Vaishali Patel ◽  
Dustin Charles ◽  
Matthew Swain ◽  
Farzad Mostashari
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Electronic Health ◽  
Electronic Health Information

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.

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