The role of patient engagement in patient-centric health information exchange (HIE) initiatives: an empirical study in the United States

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pouyan Esmaeilzadeh ◽  
Spurthy Dharanikota ◽  
Tala Mirzaei
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
The United States ◽  
Willingness To Participate ◽  
Healthcare Organizations ◽  
Content Type ◽  
Patient Centric

PurposePatient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.Design/methodology/approachThe authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).FindingsThe proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.Originality/valueThe authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Missing Link of the Health Information Exchange Loop

2017 ◽  
pp. 1185-1196
Author(s):  
Alice Noblin ◽  
Kendall Cortelyou-Ward
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Medical Data ◽  
Patient Portals ◽  
Record Keeping ◽  
Care Industry ◽  
Basic Services

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.

scholarly journals Perspectives of Patients, Health Care Professionals, and Developers Toward Blockchain-Based Health Information Exchange: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Keehyuck Lee ◽  
Kahyun Lim ◽  
Se Young Jung ◽  
Hyerim Ji ◽  
Kyungpyo Hong ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Health Management ◽  
The United States ◽  
Record System

BACKGROUND Although the electronic health record system adoption rate has reached 96% in the United States, implementation and usage of health information exchange (HIE) is still lagging behind. Blockchain has come into the spotlight as a technology to solve this problem. However, there have been no studies assessing the perspectives of different stakeholders regarding blockchain-based patient-centered HIE. OBJECTIVE The objective of this study was to analyze the awareness among patients, health care professionals, and information technology developers toward blockchain-based HIE, and compare their different perspectives related to the platform using a qualitative research methodology. METHODS In this qualitative study, we applied grounded theory and the Promoting Action on Research Implementation in the Health Service (PARiHS) framework. We interviewed 7 patients, 7 physicians, and 7 developers, for a total of 21 interviewees. RESULTS Regarding the leakage of health information, the patient group did not have concerns in contrast to the physician and developer groups. Physicians were particularly concerned about the fact that errors in the data cannot be easily fixed due to the nature of blockchain technology. Patients were not against the idea of providing information for clinical trials or research institutions. They wished to be provided with the results of clinical research rather than being compensated for providing data. The developers emphasized that blockchain must be technically mature before it can be applied to the health care scene, and standards of medical information to be exchanged must first be established. CONCLUSIONS The three groups’ perceptions of blockchain were generally positive about the idea of patients having the control of sharing their own health information. However, they were skeptical about the cooperation among various institutions and implementation for data standardization in the establishment process, in addition to how the service will be employed in practice. Taking these factors into consideration during planning, development, and operation of a platform will contribute to establishing practical treatment plans and tracking in a more convenient manner for both patients and physicians. Furthermore, it will help expand the related research and health management industry based on blockchain.

scholarly journals Perspectives of Patients, Health Care Professionals, and Developers Toward Blockchain-Based Health Information Exchange: Qualitative Study

10.2196/18582 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e18582
Author(s):  
Keehyuck Lee ◽  
Kahyun Lim ◽  
Se Young Jung ◽  
Hyerim Ji ◽  
Kyungpyo Hong ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Health Management ◽  
The United States ◽  
Record System

Background Although the electronic health record system adoption rate has reached 96% in the United States, implementation and usage of health information exchange (HIE) is still lagging behind. Blockchain has come into the spotlight as a technology to solve this problem. However, there have been no studies assessing the perspectives of different stakeholders regarding blockchain-based patient-centered HIE. Objective The objective of this study was to analyze the awareness among patients, health care professionals, and information technology developers toward blockchain-based HIE, and compare their different perspectives related to the platform using a qualitative research methodology. Methods In this qualitative study, we applied grounded theory and the Promoting Action on Research Implementation in the Health Service (PARiHS) framework. We interviewed 7 patients, 7 physicians, and 7 developers, for a total of 21 interviewees. Results Regarding the leakage of health information, the patient group did not have concerns in contrast to the physician and developer groups. Physicians were particularly concerned about the fact that errors in the data cannot be easily fixed due to the nature of blockchain technology. Patients were not against the idea of providing information for clinical trials or research institutions. They wished to be provided with the results of clinical research rather than being compensated for providing data. The developers emphasized that blockchain must be technically mature before it can be applied to the health care scene, and standards of medical information to be exchanged must first be established. Conclusions The three groups’ perceptions of blockchain were generally positive about the idea of patients having the control of sharing their own health information. However, they were skeptical about the cooperation among various institutions and implementation for data standardization in the establishment process, in addition to how the service will be employed in practice. Taking these factors into consideration during planning, development, and operation of a platform will contribute to establishing practical treatment plans and tracking in a more convenient manner for both patients and physicians. Furthermore, it will help expand the related research and health management industry based on blockchain.

Missing Link of the Health Information Exchange Loop

2016 ◽  
Vol 6 (2) ◽  
pp. 46-55
Author(s):  
Alice M. Noblin ◽  
Kendall Cortelyou-Ward
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Health Care Industry ◽  
Patient Portals ◽  
Record Keeping ◽  
Care Industry ◽  
Basic Services

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.

scholarly journals Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings

2014 ◽  
Vol 33 (9) ◽  
pp. 1672-1679 ◽  
Author(s):  
Michael F. Furukawa ◽  
Jennifer King ◽  
Vaishali Patel ◽  
Chun-Ju Hsiao ◽  
Julia Adler-Milstein ◽  
...  
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Substantial Progress ◽  
Ehr Adoption

Regional and Community Health Information Exchange in the United States

2011 ◽  
pp. 198-218 ◽  
Author(s):  
Adi V. Gundlapalli ◽  
Jonathan H. Reid ◽  
Jan Root ◽  
Wu Xu
Keyword(s):  
United States ◽  
Patient Care ◽  
Community Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Business Case ◽  
The United States ◽  
Healthcare Systems ◽  
Secure Information

A fundamental premise of continuity in patient care and safety suggests timely sharing of health information among different providers at the point of care and after the visit. In most healthcare systems, this is achieved through exchange of written medical information, phone calls and conversations. In an ideal world, this exchange of health information between disparate providers, healthcare systems, laboratories, pharmacies and payers would be achieved electronically and seamlessly. The potential benefits of electronic health exchange are improved patient care, increased efficiency of the healthcare system and decreased costs. The reality is that health information is electronically exchanged only to a limited extent within local communities and regions, much less nationally and internationally. One main challenge has been the inability of health information exchange organizations to develop a solid business case. Other challenges have been socio-political in that data ownership and stewardship have not been clearly resolved. Technological improvements over the past 20 years have provided significant advances towards safe and secure information exchange. This chapter provides a general overview of community health information exchange in the United States of America, its history and details of challenges faced by stakeholders. The lessons learned from successes and failures, research and knowledge gaps and future prospects are also discussed. Current and future technologies to facilitate and invigorate health information exchange are highlighted. Two examples of successful regional health information exchanges in the US states of Utah and Indiana are highlighted.

scholarly journals A Patient-Centric Health Information Exchange Framework Using Blockchain Technology

2020 ◽  
Vol 24 (8) ◽  
pp. 2169-2176 ◽  
Author(s):  
Yan Zhuang ◽  
Lincoln R. Sheets ◽  
Yin-Wu Chen ◽  
Zon-Yin Shae ◽  
Jeffrey J.P. Tsai ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Blockchain Technology ◽  
Patient Centric

scholarly journals State of the Art in Clinical Informatics: Evidence and Examples

2013 ◽  
Vol 22 (01) ◽  
pp. 13-19 ◽  
Author(s):  
A. B. McCoy ◽  
A. Wright ◽  
G. Eysenbach ◽  
B. A. Malin ◽  
E. S. Patterson ◽  
...  
Keyword(s):  
Health Information ◽  
Language Processing ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
The United States ◽  
Clinical Informatics ◽  
Privacy And Security ◽  
Health Records

Summary Objective: The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in clinical practice. Methods: In this review, we present recent evidence on clinical informatics in the United States covering three themes: 1) clinical informatics systems and interventions for providers, including EHRs, CPOE, CDS, and health information exchange; 2) consumer health informatics systems, including personal health records and web-based and mobile HIT; and 3) methods and governance for clinical informatics, including EHR usability; data mining, text mining, natural language processing, privacy, and security. Results: Substantial progress has been made in demonstrating that various clinical informatics methodologies and applications improve the structure, process, and outcomes of various facets of the healthcare system. Conclusion: Over the coming years, much more will be expected from the field. As we move past the “early adopters” in Rogers' diffusion of innovations' curve through the “early majority” and into the “late majority,” there will be a crucial need for new research methodologies and clinical applications that have been rigorously demonstrated to work (i.e., to improve health outcomes) in multiple settings with different types of patients and clinicians.

scholarly journals Consumer perceptions of health IT utilization and benefits

JAMIA Open ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Sue S Feldman ◽  
Grishma P Bhavsar ◽  
Benjamin L Schooley
Keyword(s):  
Conceptual Framework ◽  
Health Information ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Consumer Perceptions ◽  
Bivariate Analysis ◽  
Health It ◽  
Cross Sectional Survey ◽  
Cross Sectional

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.

scholarly journals Hospital adoption of multiple health information exchange approaches and information accessibility

2020 ◽  
Vol 27 (4) ◽  
pp. 577-583
Author(s):  
Jordan Everson ◽  
Evan Butler
Keyword(s):  
Health Information ◽  
Information Integration ◽  
Information Exchange ◽  
Fixed Effects ◽  
Health Information Exchange ◽  
The United States ◽  
Secure Messaging ◽  
American Hospital ◽  
American Hospital Association ◽  
Percentage Points

Abstract Objective Hospital engagement in electronic health information exchange (HIE) has increased over recent years. We aimed to 1) determine the change in adoption of 3 types of information exchange: secure messaging, provider portals, and use of an HIE; and 2) to assess if growth in each approach corresponded to increased ability to access and integrate patient information from outside providers. Methods Panel analysis of all nonfederal, acute care hospitals in the United States using hospital- and year-fixed effects. The sample consisted of 1917 hospitals that responded to the American Hospital Association Information Technology Supplement every year from 2014 to 2016. Results Adoption of each approach increased by 9–15 percentage points over the study period. The average number of HIE approaches used by each hospital increased from 1.0 to 1.4. Adoption of each approach was associated with increased likelihood that providers routinely had necessary outside information of 4.2–12.7 percentage points and 4.5–13.3 percentage points increase in information integration. Secure messaging was associated with the largest increase in both. Adoption of 1 approach increased the likelihood of having outside information by 10.3 percentage points, while adopting a second approach further increased the likelihood by 9.5 percentage points. Trends in number of approaches and integration were similar. Discussion/Conclusion No single HIE tool provided high levels of usable, integrated health information. Instead, hospitals benefited from adopting multiple tools. Policy initiatives that reduce the complexity of enabling high value HIE could result in broader adoption of HIE and use of information to inform care.

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