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

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 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 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.

Outcomes Assessment of the Regional Health Information Exchange

2011 ◽  
Vol 50 (04) ◽  
pp. 308-318 ◽  
Author(s):  
P. Asikainen ◽  
M. Gissler ◽  
K. Siponen ◽  
M. Maass ◽  
K. Saranto ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Health Care Delivery ◽  
Information Exchange ◽  
Laboratory Tests ◽  
Health Information Exchange ◽  
Care Delivery ◽  
Emergency Department Visits ◽  
Health Care Information ◽  
Care Information

SummaryBackground: The implementation of a technology such as health information exchange (HIE) through a Regional Health Information System (RHIS) may improve the mobilization of health care information electronically across organizations. There is a need to coordinate care and bring together regional and local stakeholders.Objectives: To describe how HIE had influenced health care delivery in one hospital district area in Finland.Method: Trend analysis was used to evaluate the influence of a regional HIE. We conducted a retrospective, longitudinal study for the period 2004–2008 for the eleven federations of municipalities in the study area. We reviewed statistical health data from the time of implementation of an RHIS. The t-test was used to determine statistical significance. The selected outcomes were the data obtained from the regional database on total appointments, emergency department visits, laboratory tests and radiology examinations, and selected laboratory tests and radiology examinations carried out in both primary care and special health care.Results: Access to HIE may have influenced health care delivery in the study area. There are indications that there is a connection between access to regional HIE and the number of laboratory tests and radiology examinations performed in both primary care and specialized health care, as observed in the decreased frequency in outcomes such as radiology examinations, number of appointments, and emergency department visits in the study environment. The decreased frequencies of the latter suggest an increased efficiency of outpatient care, but we were not able to estimate to what extent the readily available comprehensive clinical information contributed to these trends.Conclusion: Outcome assessment of HIE through an RHIS is essential for the success of health information technology (HIT) and as evidence to use in the decision-making process. As health care information becomes more digital, it increases the potential for a strong HIE effect on health care delivery.

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