scholarly journals Defining Health Information Exchange: Scoping Review of Published Definitions

2017 ◽  
Vol 23 (4) ◽  
pp. 684 ◽  
Author(s):  
Ather Akhlaq ◽  
Aziz Sheikh ◽  
Claudia Pagliari
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Informatics ◽  
Information Science ◽  
Health Information Exchange ◽  
Grey Literature ◽  
Clinical Information ◽  
Scientific Databases ◽  
Literature Searches ◽  
Generic Term

ObjectiveThe term Health Information Exchange (HIE) is often used in health informatics, yet uncertainties remain about its precise meaning. This study aimed to capture and analyse existing definitions in order to map variations in its use and the concepts associated with it.MethodsSystematic literature search to identify published definitions of HIE and equivalent terms such as Clinical Information Exchange. Medline, Web of Science, Library Information Science and Technology Abstracts, EMBASE and CINAHL Plus were searched to identify relevant research, and Google to identify grey literature. Searches were not limited by language or date of publication. In order to warrant inclusion documents had to either define the concept explicitly or do so via a concrete description.  Included references were tabulated by author affiliation, source of quote, year of publication, country of origin and definitions and the definitions themselves were analysed thematically.ResultsSearches revealed 603 scientific articles and 5981 website links. From these, a total of 268 unique definitions of HIE were identified and extracted: 103 from scientific databases and 165 from Google. Eleven constructs emerged from the thematic analysis. Contextual factors influenced the emphasis of the definitions and the framing of HIE as a concept/process, a set of enabling technologies, or an entity/organisation.ConclusionsHIE is a complex and evolving concept and uses of the term vary across settings, presenting challenges for communication.  Developing a generic term is difficult, given the importance of context, but the authors suggest one covering key attributes of HIE, which may be helpful.

scholarly journals Clinical Information Systems – Seen through the Ethics Lens

2020 ◽  
Vol 29 (01) ◽  
pp. 104-114
Author(s):  
Ursula H. Hübner ◽  
Nicole Egbert ◽  
Georg Schulte
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Information Exchange ◽  
Ethics Education ◽  
Health Information Exchange ◽  
Evaluation Studies ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Smart Systems

Objective: The more people there are who use clinical information systems (CIS) beyond their traditional intramural confines, the more promising the benefits are, and the more daunting the risks will be. This review thus explores the areas of ethical debates prompted by CIS conceptualized as smart systems reaching out to patients and citizens. Furthermore, it investigates the ethical competencies and education needed to use these systems appropriately. Methods: A literature review covering ethics topics in combination with clinical and health information systems, clinical decision support, health information exchange, and various mobile devices and media was performed searching the MEDLINE database for articles from 2016 to 2019 with a focus on 2018 and 2019. A second search combined these keywords with education. Results: By far, most of the discourses were dominated by privacy, confidentiality, and informed consent issues. Intertwined with confidentiality and clear boundaries, the provider-patient relationship has gained much attention. The opacity of algorithms and the lack of explicability of the results pose a further challenge. The necessity of sociotechnical ethics education was underpinned in many studies including advocating education for providers and patients alike. However, only a few publications expanded on ethical competencies. In the publications found, empirical research designs were employed to capture the stakeholders’ attitudes, but not to evaluate specific implementations. Conclusion: Despite the broad discourses, ethical values have not yet found their firm place in empirically rigorous health technology evaluation studies. Similarly, sociotechnical ethics competencies obviously need detailed specifications. These two gaps set the stage for further research at the junction of clinical information systems and ethics.

scholarly journals Findings from 2017 on Health Information Management

2018 ◽  
Vol 27 (01) ◽  
pp. 067-073
Author(s):  
Meryl Bloomrosen ◽  
Eta Berner ◽  
Keyword(s):  
Health Information ◽  
Information Management ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Health Information Management ◽  
Bibliographic Databases ◽  
Major Theme ◽  
Multiple Sources ◽  
Exchange Governance

Objective: To summarize the recent literature and research and present a selection of the best papers published in 2017 in the field of Health Information Management (HIM) and Health Informatics. Methods: A systematic review of the literature was performed by the two HIM section editors of the International Medical Informatics Association (IMIA) Yearbook with the help of a medical librarian. We searched bibliographic databases for HIM-related papers using both MeSH descriptors and keywords in titles and abstracts. A shortlist of 15 candidate best papers was first selected by section editors before being peer-reviewed by independent external reviewers. Results: Health Information Exchange was a major theme within candidate best papers. The four papers ultimately selected as ‘Best Papers’ represent themes that include health information exchange, governance and policy issues, results of health information exchange, and methods of integrating information from multiple sources. Other articles within the candidate best papers include these themes as well as those focusing on authentication and de-identification and usability of information systems. Conclusions: The papers discussed in the HIM section of IMIA Yearbook reflect the overall theme of the 2018 edition of the Yearbook, i.e., the tension between privacy and access to information. While most of the papers focused on health information exchange, which reflects the “access” side of the equation, most of the others addressed privacy issues. This synopsis discusses these key issues at the intersection of HIM and informatics.

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 Findings from the 2021 Yearbook Section on Health Information Management

2021 ◽  
Vol 30 (01) ◽  
pp. 084-090
Author(s):  
Meryl Bloomrosen ◽  
Eta S. Berner ◽  
Keyword(s):  
Data Quality ◽  
Health Information ◽  
Information Management ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Health Information Management ◽  
Bibliographic Databases ◽  
Public Health Informatics ◽  
Health Records

Objectives: To summarize the recent literature and research and present a selection of the best papers published in 2020 in the field of Health Information Management (HIM) and Health Informatics. Methods: A systematic review of the literature for the IMIA Yearbook HIM section was performed by the two section editors with the help of a medical librarian. We searched bibliographic databases for HIM-related papers using both MeSH headings and keywords in titles and abstracts. A shortlist of the fifteen best candidate papers was first selected by section editors before being peer-reviewed by independent external reviewers. Results: The three major themes of Health Information Exchange (transmitting, sharing, and accessing patient health-related data and information) (HIE), Data Quality, and Privacy and Security make up 80% of the fifteen papers, with individual papers on personal health records, information governance and the professionalism of the HIM field. Conclusions: Traditional HIM concerns about HIM practice and workforce as well as issues about the data in electronic health records (EHRs) including data quality, coding, health information exchange among entities within the healthcare systems and privacy and confidentiality continue to be a large part of the HIM research literature. Although there was little research applying these themes to pandemic concerns, HIM professionals have the expertise to make ccontributions to public health informatics research and this research would benefit from their involvement.

scholarly journals Emerging and Established Trends to Support Secure Health Information Exchange

2021 ◽  
Vol 3 ◽  
Author(s):  
Emmanouil G. Spanakis ◽  
Stelios Sfakianakis ◽  
Silvia Bonomi ◽  
Claudio Ciccotelli ◽  
Sabina Magalini ◽  
...  
Keyword(s):  
Health Care ◽  
Information Sharing ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Implementation Strategies ◽  
Clinical Information ◽  
Secure Information ◽  
Extensive Evaluation ◽  
Secure Information Sharing

This work aims to provide information, guidelines, established practices and standards, and an extensive evaluation on new and promising technologies for the implementation of a secure information sharing platform for health-related data. We focus strictly on the technical aspects and specifically on the sharing of health information, studying innovative techniques for secure information sharing within the health-care domain, and we describe our solution and evaluate the use of blockchain methodologically for integrating within our implementation. To do so, we analyze health information sharing within the concept of the PANACEA project that facilitates the design, implementation, and deployment of a relevant platform. The research presented in this paper provides evidence and argumentation toward advanced and novel implementation strategies for a state-of-the-art information sharing environment; a description of high-level requirements for the transfer of data between different health-care organizations or cross-border; technologies to support the secure interconnectivity and trust between information technology (IT) systems participating in a sharing-data “community”; standards, guidelines, and interoperability specifications for implementing a common understanding and integration in the sharing of clinical information; and the use of cloud computing and prospectively more advanced technologies such as blockchain. The technologies described and the possible implementation approaches are presented in the design of an innovative secure information sharing platform in the health-care domain.

scholarly journals Adoption of Health Information Exchange by Emergency Physicians at Three Urban Academic Medical Centers

2011 ◽  
Vol 02 (03) ◽  
pp. 263-269 ◽  
Author(s):  
J. Shapiro ◽  
S. Vaidya ◽  
G. Kuperman ◽  
N. Genes
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Clinical Information ◽  
Data Availability ◽  
Emergency Physicians ◽  
Structured Interviews ◽  
Successful Retrieval ◽  
Data Elements

Summary Objectives: Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs). Methods: We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among “users” with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among “non-users” with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability. Results: Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login, half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training. Conclusions: Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.

scholarly journals Improving Access to Longitudinal Patient Health Information within an Emergency Department

2012 ◽  
Vol 03 (03) ◽  
pp. 290-300 ◽  
Author(s):  
S. Shen ◽  
D.A. Dorr ◽  
G. Hripcsak ◽  
L. Heermann ◽  
S.P. Narus ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
User Authentication ◽  
Tracking System ◽  
Clinical Information ◽  
Before And After ◽  
Patient Health ◽  
The Impact

SummaryWe designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives.

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