scholarly journals Health Information Exchange and Ambulatory Quality of Care

2012 ◽  
Vol 03 (02) ◽  
pp. 197-209 ◽  
Author(s):  
Y. Barrón ◽  
R.V. Dhopeshwarkar ◽  
R. Kaushal ◽  
L.M. Kern
Keyword(s):  
Quality Of Care ◽  
Health Information ◽  
Clinical Data ◽  
Information Exchange ◽  
Primary Care Physicians ◽  
Health Information Exchange ◽  
New York State ◽  
Care Quality

SummaryBackground: Health information exchange is a national priority, but there is limited evidence of its effectiveness.Objective: We sought to determine the effect of health information exchange on ambulatory quality.Methods: We conducted a retrospective cohort study over two years of 138 primary care physicians in small group practices in the Hudson Valley region of New York State. All physicians had access to an electronic portal, through which they could view clinical data (such as laboratory and radiology test results) for their patients over time, regardless of the ordering physician. We considered 15 quality measures that were being used by the community for a pay-for-performance program, as well as the subset of 8 measures expected to be affected by the portal. We adjusted for 11 physician characteristics (including health care quality at baseline).Results: Nearly half (43%) of the physicians were portal users. Non-users performed at or above the regional benchmark on 48% of the measures at baseline and 49% of the measures at follow-up (p = 0.58). Users performed at or above the regional benchmark on 57% of the measures at baseline and 64% at follow-up (p<0.001). Use of the portal was independently associated with higher quality of care at follow-up for those measures expected to be affected by the portal (p = 0.01), but not for those not expected to be affected by the portal (p = 0.12).Conclusions: Use of an electronic portal for viewing clinical data was associated with modest improvements in ambulatory quality.

scholarly journals What Affects Clinicians’ Usage of Health Information Exchange?

2011 ◽  
Vol 02 (03) ◽  
pp. 250-262 ◽  
Author(s):  
L. Volk ◽  
S. Simon ◽  
D. Bates ◽  
R. Rudin
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Healthcare Providers ◽  
Care Quality ◽  
Time Savings ◽  
And Training ◽  
Exchange Health Information

SummaryBackground: The ability to electronically exchange health information among healthcare providers holds enormous promise to improve care coordination and reduce costs. Provider-to-provider data exchange is an explicit goal of the American Recovery and Reinvestment Act of 2009 and may be essential for the long-term success of the Affordable Care Act of 2010. However, little is known about what factors affect clinicians’ usage of health information exchange (HIE) functionality.Objective: To identify factors that affect clinicians’ HIE usage - in terms of frequency of contributing data to and accessing data from aggregate patient records - and suggest policies for fostering its usage.Methods: We performed a qualitative study using grounded theory by interviewing clinician-users and HIE staff of one operational HIE which supported aggregate patient record functionality. Fifteen clinicians were interviewed for one hour each about what factors affect their HIE usage. Five HIE staff were asked about technology and training issues to provide context. Interviews were recorded, transcribed and analyzed. Recruitment excluded clinicians with little or no familiarity with the HIE and was restricted to one community and a small number of specialties.Results: Clinicians were motivated to access the HIE by perceived improvements in care quality and time savings, but their motivation was moderated by an extensive list of factors including gaps in data, workflow issues and usability issues. HIE access intensities varied widely by clinician. Data contribution intensities to the HIE also varied widely and were affected by billing concerns and time constraints.Conclusions: Clinicians, EHR and HIE product vendors and trainers should work toward integrating HIE into clinical workflows. Policies should create incentives for HIE organizations to assist clinicians in using HIE, develop measures of HIE contributions and accesses, and create incentives for clinicians to contribute data to HIEs.

scholarly journals Drivers of information disclosure on health information exchange platforms: insights from an exploratory empirical study

2015 ◽  
Vol 22 (6) ◽  
pp. 1183-1186 ◽  
Author(s):  
Niam Yaraghi ◽  
Raj Sharman ◽  
Ram Gopal ◽  
Ranjit Singh ◽  
R Ramesh
Keyword(s):  
Primary Care ◽  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Information Disclosure ◽  
Primary Care Physicians ◽  
Medical Information ◽  
Health Information Exchange ◽  
Care Physician ◽  
Willingness To Disclose

Abstract Objective The objective of this research is to empirically explore the drivers of patients’ consent to sharing of their medical records on health information exchange (HIE) platforms. Materials and Methods The authors analyze a dataset consisting of consent choices of 20 076 patients in Western New York. A logistic regression is applied to empirically investigate the effects of patients’ age, gender, complexity of medical conditions, and the role of primary care physicians on patients’ willingness to disclose medical information on HIE platforms. Results The likelihood of providing consent increases by age (odds ratio (OR) = 1.055; P  &lt; .0001). Female patients are more likely to provide consent (OR = 1.460; P  = .0003). As the number of different physicians involved in the care of the patient increases, the odds of providing consent slightly increases (OR = 1.024; P  = .0031). The odds of providing consent is significantly higher for the patients whom a primary care physician has been involved in their medical care (OR = 1.323; P  &lt; .0001). Conclusion Individual-level characteristics are important predictors of patients’ willingness to disclose their medical information on HIE platforms.

scholarly journals Identifying homelessness using health information exchange data

2015 ◽  
Vol 22 (3) ◽  
pp. 682-687 ◽  
Author(s):  
John Zech ◽  
Gregg Husk ◽  
Thomas Moore ◽  
Gilad J Kuperman ◽  
Jason S Shapiro
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Housing Status ◽  
Number Of Patients ◽  
Address Data ◽  
Patients Experience ◽  
Exchange Data

Abstract Background Homeless patients experience poor health outcomes and consume a disproportionate amount of health care resources compared with domiciled patients. There is increasing interest in the federal government in providing care coordination for homeless patients, which will require a systematic way of identifying these individuals. Objective We analyzed address data from Healthix, a New York City–based health information exchange, to identify patterns that could indicate homelessness. Methods Patients were categorized as likely to be homeless if they registered with the address of a hospital, homeless shelter, place of worship, or an address containing a keyword synonymous with “homelessness.” Results We identified 78 460 out of 7 854 927 Healthix patients (1%) as likely to have been homeless over the study period of September 30, 2008 to July 19, 2013. We found that registration practices for these patients varied widely across sites. Conclusions The use of health information exchange data enabled us to identify a large number of patients likely to be homeless and to observe the wide variation in registration practices for homeless patients within and across sites. Consideration of these results may suggest a way to improve the quality of record matching for homeless patients. Validation of these results is necessary to confirm the homeless status of identified individuals. Ultimately, creating a standardized and structured field to record a patient’s housing status may be a preferable approach.

scholarly journals Resource Profile: The Regenstrief Institute COVID-19 Research Data Commons (CoRDaCo)

2021 ◽  
Author(s):  
Katie S. Allen ◽  
Nader Zidan ◽  
Vishal Dey ◽  
Eneida Mendonca ◽  
Shaun Grannis ◽  
...  
Keyword(s):  
Health Information ◽  
Clinical Data ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Primary Objective ◽  
Research Data ◽  
Early Warning Score ◽  
Multiple Sources ◽  
Data Repositories ◽  
Data Commons

The primary objective of the COVID-19 Research Data Commons (CoRDaCo) is to provide broad and efficient access to a large corpus of clinical data related to COVID-19 in Indiana, facilitating research and discovery. This curated collection of data elements provides information on a significant portion of COVID-19 positive patients in the State from the beginning of the pandemic, as well as two years of health information prior its onset. CoRDaCo combines data from multiple sources, including clinical data from a large, regional health information exchange, clinical data repositories of two health systems, and state laboratory reporting and vital records, as well as geographic-based social variables. Clinical data cover information such as healthcare encounters, vital measurements, laboratory orders and results, medications, diagnoses, the Charlson Comorbidity Index and Pediatric Early Warning Score, COVID-19 vaccinations, mechanical ventilation, restraint use, intensive care unit and ICU and hospital lengths of stay, and mortality. Interested researchers can visit ridata.org or email [email protected] to discuss access to CoRDaCo.

scholarly journals Association between use of a health information exchange system and hospital admissions

2014 ◽  
Vol 05 (01) ◽  
pp. 219-231 ◽  
Author(s):  
L.M. Kern ◽  
T.R. Campion ◽  
M.D. Silver ◽  
R. Kaushal ◽  
J.R. Vest
Keyword(s):  
Health Information ◽  
Patient Information ◽  
Information Exchange ◽  
Hospital Admissions ◽  
Health Information Exchange ◽  
New York State ◽  
Cost Savings ◽  
Exchange System ◽  
Potential Cost ◽  
Financial Investment

SummaryObjective: Relevant patient information is frequently difficult to obtain in emergency department (ED) visits. Improved provider access to previously inaccessible patient information may improve the quality of care and reduce hospital admissions. Health information exchange (HIE) systems enable access to longitudinal, community-wide patient information at the point of care. However, the ability of HIE to avert admissions is not well demonstrated. We sought to determine if HIE system usage is correlated with a reduction in admissions via the ED.Methods: We identified 15,645 adults from New York State with an ED visit during a 6-month period, all of whom consented to have their information accessible in the HIE system, and were continuously enrolled in two area health plans. Using claims we determined if the ED encounter resulted in an admission. We used the HIE’s system log files to determine usage during the encounter. We determined the association between HIE system use and the likelihood of admission to the hospital from the ED and potential cost savings.Results: The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding (odds ratio = 0.70; 95%C I= 0.52, 0.95). The annual savings in the sample was $357,000.Conclusion: These findings suggest that the use of an HIE system may reduce hospitalizations from the ED with resultant cost savings. This is an important outcome given the substantial financial investment in interventions designed to improve provider access to patient information in the US.Citation: Vest JR, Kern LM, Campion TR Jr, Silver MD, Kaushal R. Association between use of a health information exchange system and hospital admissions. Appl Clin Inf 2014; 5: 219–231 http://dx.doi.org/10.4338/ACI-2013-10-RA-0083

Health Information Exchange for Improving the Efficiency and Quality of Healthcare Delivery

2011 ◽  
pp. 352-374 ◽  
Author(s):  
Jing Shi ◽  
Sudhindra Upadhyaya ◽  
Ergin Erdem
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Critical Role ◽  
Healthcare Delivery ◽  
Cost Effective ◽  
Quality Of Healthcare ◽  
Future Research ◽  
The Right

In healthcare industry, providers, patients, and all other stakeholders must have the right information at the right time for achieving efficient and cost effective services. Exchange of information between the heterogeneous system entities plays a critical role. Health information exchange (HIE) is not only a process of transmitting data, but also a platform for streamlining operations to improve healthcare delivery in a secure manner. In this chapter, we present a comprehensive view of electronic health record (EHR) systems and HIE by presenting their architecture, benefits, challenges, and other related issues. While providing information on the current state of EHR/HIE applications, we also discuss advanced issues and secondary uses of HIE implementations, and shed some light on the future research in this area by highlighting the challenges and potentials.

scholarly journals State Funding for Health Information Technology and Selected Ambulatory Healthcare Quality Measures

2014 ◽  
Vol 05 (02) ◽  
pp. 594-602 ◽  
Author(s):  
M. Silver ◽  
R. Kaushal ◽  
L. M. Kern ◽  
Keyword(s):  
Primary Care ◽  
New York ◽  
Quality Of Care ◽  
Primary Care Physicians ◽  
New York State ◽  
Quality Measures ◽  
State Funding ◽  
Health It ◽  
York State

SummaryBackground: Previous studies on the effects of health information technology (health IT) on ambulatory quality have had mixed results. New York State has invested heavily in health IT throughout the State, creating a unique opportunity to assess effects on health care quality across multiple communities.Objective: To determine any association between primary care providers’ receipt of funding from New York State’s Healthcare Efficiency and Affordability Law for New Yorkers Program (HEAL NY) and ambulatory quality of careMethods: A statewide, longitudinal cohort study of primary care physicians in New York State was conducted. Data regarding which primary care physicians received funding through the HEAL NY program (Phase 5 or Phase 10) in 2008 or 2009 were obtained from the New York State Department of Health. Health care quality in 2010 was measured using claims data that had been aggregated across 7 commercial health plans across the state. Physicians were divided into 2 groups, based on receipt of HEAL funding (yes/no). Any association was measured between study group and each of 7 quality measures, all of which appear in the Stage 1 federal Meaningful Use program. Negative binomial regression was used, adjusting for provider gender and specialty.Results: The study included 3,988 primary care providers, of whom 863 (22%) had received HEAL NY funding. The HEAL-funded physicians provided higher quality of care on 5 of the 7 measures: breast cancer screening, eye exams in patients with diabetes, nephropathy screening in patients with diabetes, influenza vaccination and pneumococcal vaccination (p<0.0001 for all adjusted comparisons). The HEAL-funded group provided higher quality of care by an absolute 2 to 6 percentage points per measure for those 5 measures.Conclusion: Primary care physicians who received state funding for health IT provided higher quality of care than those who did not receive such funding.Citation: Kern LM, Silver M, Kaushal R; with the HITEC Investigators. State funding for health information technology and selected ambulatory healthcare quality measures. Appl Clin Inf 2014; 5: 594–602 http://dx.doi.org/10.4338/ACI-2013-12-RA-0108

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