Use of health information exchange in the continuity of care as viewed by patients and nurses (Preprint)

2019 ◽  
Author(s):  
Michal Itzhaki ◽  
Ella Koren ◽  
Khaled Abu Hussien ◽  
Liron Levy ◽  
Irit Gantz ◽  
...  

BACKGROUND Patients' attitudes towards sharing their personal health information are critical for implementation of Health Information Exchange (HIE). Nurses contribute significantly to information sharing within the care continuum in hospitals and community. OBJECTIVE The purpose of this study was to examine the awareness and readiness of patients and nurses to use HIE. METHODS A cross sectional study among 312 inpatients with a chronic illness, 110 nurses working in internal wards, and 55 contact nurses working in a large Health Maintenance Organization. Multiple linear regressions were performed to assess the associations between knowledge, attitudes, socio-demographics, and both the readiness and intention to use HIE. RESULTS Mean levels of awareness were low across all three groups. The readiness to share information with medical healthcare providers was higher than the readiness to share information with agents not involved in direct care. Contact nurses expressed a more positive attitude than internal ward nurses or patients and were more willing than patients to share information with health care workers. All nurses (Internal ward and contact) were more willing to share information with medical agents not involved in direct care as compared to patients. Contact nurses expressed a significantly greater intention to use HIE than did internal ward nurses or patients CONCLUSIONS Before implementation of an HIE system, it is important to raise awareness, readiness, and intention to use HIE among the general public, nurses, and other medical staff. Policy makers should organize national campaigns under the auspices of the Ministry of Health, in order to present the advantages of HIE and provide detailed information about the systems. CLINICALTRIAL None

2020 ◽  
Author(s):  
Michal Itzhaki ◽  
Ella Koren ◽  
Khaled Abu Hussien ◽  
Liron Levy ◽  
Irit Gantz ◽  
...  

Abstract Background: Patients' attitudes towards sharing their personal health information are critical for implementation of Health Information Exchange (HIE). Nurses contribute significantly to information sharing within the care continuum in hospitals and community. The purpose of this study was to examine the awareness and readiness of chronic ill patients and nurses to use HIE.Methods: A cross sectional study among 312 inpatients with a chronic illness, 110 nurses working in internal wards, and 55 contact nurses working in a large Health Maintenance Organization. Multiple linear regressions were performed to assess the associations between knowledge, attitudes, socio-demographics, and both the readiness and intention to use HIE. Results: Mean levels of awareness were low across all three groups. The readiness to share information with medical healthcare providers was higher than the readiness to share information with agents not involved in direct care. Contact nurses expressed more positive attitudes than internal ward nurses or patients (F=11.25; p=.0001) and were more willing than patients to share information with health care workers (F=16.786; p=0001). All nurses (Internal ward and contact) were more willing to share information with medical agents not involved in direct care as compared to patients (F=8.072; p=.0001). Contact nurses expressed a significantly greater intention to use HIE than did internal ward nurses or patients (F=9.825; p=.0001), Knowledge, attitudes and being a nurse predicted the intention to share information on HIE with medical health care providers (F=29.91), and with agents not involved in direct care (F=19.65).Conclusions: Before implementation of an HIE system, it is important to raise awareness, readiness, and intention to use HIE among the general public, nurses, and other medical staff. Policy makers should organize national campaigns under the auspices of the Ministry of Health, in order to present the advantages of HIE and provide detailed information about the systems.


2018 ◽  
Vol 25 (8) ◽  
pp. 989-999 ◽  
Author(s):  
Jean O Taylor ◽  
Andrea L Hartzler ◽  
Katie P Osterhage ◽  
George Demiris ◽  
Anne M Turner

Abstract Objective Although family and friends (FF) often play a significant support role in the health of older adults (OA), we know little about their role in personal health information management (PHIM). To address this gap and inform the design of PHIM tools, we describe the work, needs, and barriers of FF in the context of PHIM for OAs. Methods We conducted semi-structured telephone interviews with 52 FF identified by OA as being important in their health and PHIM. We analyzed interview transcripts for themes about FF information work, barriers, and support needs. Results FF play a supportive role in OA health maintenance, medical encounters, decision making, and daily activities. Monitoring, the ongoing process of seeking information related to the OA status, emerged as a key activity comprised of 3 phases: detection, interpretation, and action. Barriers to monitoring included OA choices and constraints, FF constraints, and difficulty with technological tools, resources, health information exchange between providers, social network dynamics, and physical distance. Conclusions FF frequently monitor for change in OA well-being, seeking up-to-date information to facilitate support of OA PHIM. Health information technology tools designed for FF can support all phases of monitoring by providing: (1) timely and granular levels of access to OA health information as the OA ages; (2) tailored health education for FF that is based on OA clinical data; and (3) networking platforms that integrate delegation, volunteering, and relevant resources, along with tools to facilitate support of OA appointment calendars and medication management. Such tools could reduce the burden of PHIM for OA and their loved ones.


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.


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.


2015 ◽  
Vol 06 (02) ◽  
pp. 248-266 ◽  
Author(s):  
M. Rantz ◽  
C. Galambos ◽  
A. Vogelsmeier ◽  
M. Flesner ◽  
L. Popejoy ◽  
...  

SummaryObjective: Our purpose was to describe how we prepared 16 nursing homes (NHs) for health information exchange (HIE) implementation.Background: NH HIE connecting internal and external stakeholders are in their infancy. U.S. initiatives are demonstrating HIE use to increase access and securely exchange personal health information to improve patient outcomes.Method: To achieve our objectives we conducted readiness assessments, performed 32 hours of clinical observation and developed 6 use cases, and conducted semi-structured interviews with 230 participants during 68 site visits to validate use cases and explore HIE.Results: All 16 NHs had technology available to support resident care. Resident care technologies were integrated much more with internal than external stakeholders. A wide range of technologies were accessible only during administrative office hours. Six non-emergent use cases most commonly communicated by NH staff were: 1) scheduling appointments, 2) laboratory specimen drawing, 3) pharmacy orders and reconciliation, 4) social work discharge planning, 5) admissions and pre-admissions, and 6) pharmacy-medication reconciliation. Emerging themes from semi-structured interviews about use cases included: availability of information technology in clinical settings, accessibility of HIE at the point of care, and policies/procedures for sending/receiving secure personal health information.Conclusion: We learned that every facility needed additional technological and human resources to build an HIE network. Also, use cases help clinical staff apply theoretical problems of HIE implementation and helps them think through the implications of using HIE to communicate about clinical care.Citation: Alexander GL, Rantz M, Galambos C, Vogelsmeier A, Flesner M, Popejoy L, Mueller J, Shumate S, Elvin M. Preparing nursing homes for the future of health information exchange. Appl Clin Inf 2015; 6: 248–266http://dx.doi.org/10.4338/ACI-2014-12-RA-0113


2019 ◽  
Author(s):  
Pouyan Esmaeilzadeh ◽  
Tala Mirzaei

BACKGROUND Nowadays, a number of mechanisms and tools are being used by health care organizations and physicians to electronically exchange the personal health information of patients. The main objectives of different methods of health information exchange (HIE) are to reduce health care costs, minimize medical errors, and improve the coordination of interorganizational information exchange across health care entities. The main challenges associated with the common HIE systems are privacy concerns, security risks, low visibility of system transparency, and lack of patient control. Blockchain technology is likely to disrupt the current information exchange models utilized in the health care industry. OBJECTIVE Little is known about patients’ perceptions and attitudes toward the implementation of blockchain-enabled HIE networks, and it is still not clear if patients (as one of the main HIE stakeholders) are likely to opt in to the applications of this technology in HIE initiatives. Thus, this study aimed at exploring the core value of blockchain technology in the health care industry from health care consumers’ views. METHODS To recognize the potential applications of blockchain technology in health care practices, we designed 16 information exchange scenarios for controlled Web-based experiments. Overall, 2013 respondents participated in 16 Web-based experiments. Each experiment described an information exchange condition characterized by 4 exchange mechanisms (ie, direct, lookup, patient-centered, and blockchain), 2 types of health information (ie, sensitive vs nonsensitive), and 2 types of privacy policy (weak vs strong). RESULTS The findings show that there are significant differences in patients’ perceptions of various exchange mechanisms with regard to patient privacy concern, trust in competency and integrity, opt-in intention, and willingness to share information. Interestingly, participants hold a favorable attitude toward the implementation of blockchain-based exchange mechanisms for privacy protection, coordination, and information exchange purposes. This study proposed the potentials and limitations of a blockchain-based attempt in the HIE context. CONCLUSIONS The results of this research should be of interest to both academics and practitioners. The findings propose potential limitations of a blockchain-based HIE that should be addressed by health care organizations to exchange personal health information in a secure and private manner. This study can contribute to the research in the blockchain area and enrich the literature on the use of blockchain in HIE efforts. Practitioners can also identify how to leverage the benefit of blockchain to promote HIE initiatives nationwide.


10.2196/26746 ◽  
2020 ◽  
Author(s):  
Randyl A. Cochran ◽  
Sue S. Feldman ◽  
Nataliya V. Ivankova ◽  
Allyson G. Hall ◽  
William Opoku-Agyeman

2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.


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