scholarly journals Preparing Nursing Homes for the Future of Health Information Exchange

2015 ◽  
Vol 06 (02) ◽  
pp. 248-266 ◽  
Author(s):  
M. Rantz ◽  
C. Galambos ◽  
A. Vogelsmeier ◽  
M. Flesner ◽  
L. Popejoy ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Use Cases ◽  
Personal Health Information ◽  
Personal Health ◽  
Structured Interviews ◽  
Resident Care ◽  
External Stakeholders

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

scholarly journals Assessing payer perspectives on health information exchange

2015 ◽  
Vol 23 (2) ◽  
pp. 297-303 ◽  
Author(s):  
Dori A Cross ◽  
Sunny C Lin ◽  
Julia Adler-Milstein
Keyword(s):  
Health Information ◽  
Clinical Data ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
The United States ◽  
Current Approach ◽  
Use Cases ◽  
Structured Interviews ◽  
Care Plans

Abstract Objective To identify factors that impede payer engagement in a health information exchange (HIE), along with organizational and policy strategies that might effectively address the impediments. Materials and Methods Qualitative analysis of semi-structured interviews with leaders from 17 varied payer organizations from across the country (e.g., large, national payers; state Blues plans; local Medicaid managed care plans). Results We found a large gap between payers’ vision of what optimal HIE should be and the current approach to HIE in the United States. Notably, payers sought to be active participants in HIE efforts – both providing claims data and accessing clinical data to support payer HIE use cases. Instead, payers were often asked by HIE efforts only to provide financial support without the option to participate in data exchange, or, when given the option, their data needs were secondary to those of providers. Discussion Efforts to engage payers in pursuit of more robust and sustainable HIE need to better align their value proposition with payer HIE use cases. This will require addressing provider concerns about payer access to clinical data. Policymakers should focus on creating the conditions for broader payer engagement by removing common obstacles, such as low provider engagement in HIE. Conclusion Despite variation in the extent to which payers engaged with current HIE efforts, there was agreement on the vision of optimal HIE and the facilitators of greater payer engagement. Specific actions by those leading HIE efforts, complemented by policy efforts nationally, could greatly increase payer engagement and enhance HIE sustainability.

scholarly journals The Potential of Blockchain Technology for Health Information Exchange: Experimental Study From Patients’ Perspectives (Preprint)

2019 ◽  
Author(s):  
Pouyan Esmaeilzadeh ◽  
Tala Mirzaei
Keyword(s):  
Health Care ◽  
Health Information ◽  
Information Exchange ◽  
Health Care Organizations ◽  
Health Information Exchange ◽  
Health Care Industry ◽  
Personal Health Information ◽  
Personal Health ◽  
Web Based ◽  
Blockchain Technology

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.

scholarly journals Monitoring for change: the role of family and friends in helping older adults manage personal health information

2018 ◽  
Vol 25 (8) ◽  
pp. 989-999 ◽  
Author(s):  
Jean O Taylor ◽  
Andrea L Hartzler ◽  
Katie P Osterhage ◽  
George Demiris ◽  
Anne M Turner
Keyword(s):  
Older Adults ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Medication Management ◽  
Well Being ◽  
Physical Distance ◽  
Personal Health Information ◽  
Personal Health ◽  
Health Maintenance

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.

Consumer Support for Health Information Exchange and Personal Health Records: A Regional Health Information Organization Survey

2010 ◽  
Vol 36 (3) ◽  
pp. 1043-1052 ◽  
Author(s):  
Vaishali N. Patel ◽  
Rina V. Dhopeshwarkar ◽  
Alison Edwards ◽  
Yolanda Barrón ◽  
Jeffrey Sparenborg ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Personal Health Records ◽  
Information Organization ◽  
Personal Health ◽  
Regional Health ◽  
Health Records

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.

To Tell or Not to Tell? Professional and Lay Perspectives on the Disclosure of Personal Health Information in Community-Based Dementia Care

2004 ◽  
Vol 23 (3) ◽  
pp. 203-215 ◽  
Author(s):  
C. Shawn Tracy ◽  
Neil Drummond ◽  
Lorraine E. Ferris ◽  
Judith Globerman ◽  
Philip C. Hébert ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Health Information ◽  
Information Exchange ◽  
Early Stage ◽  
Personal Health Information ◽  
Best Interests ◽  
Personal Health ◽  
Care Providers ◽  
Health And Social Care ◽  
Strong Control

ABSTRACTDevelopments in information technology and the ongoing restructuring of health services to increase provision in community settings militate in favour of a streamlining of communications and the exchange of information about patients among health and social care providers. Yet the principles of confidentiality and privacy appear to inhibit this process. In order to explore the practical, ethical, and legal imperatives attendant upon personal health information exchange, we conducted a series of interviews with professional care providers, persons with early-stage dementia, and their family caregivers. The findings indicate some degree of discordance. Professionals reported valuing disclosure both to colleagues and family caregivers on the basis of its being in the patients' best interests. Patients also valued inter-professional exchange, but sought strong control over disclosure to family members. Family caregivers valued being kept informed of the patient's condition, even without the latter's consent. Implications for research and policy are discussed.

scholarly journals Best Paper Selection

2018 ◽  
Vol 27 (01) ◽  
pp. 071-073
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Controlled Trial ◽  
Personal Health ◽  
Medication Discrepancies ◽  
Health Records ◽  
Architecture Model ◽  
Randomized Controlled ◽  
Cluster Randomized

Roehrs A, da Costa CA, da Rosa Righi R. OmniPHR: A distributed architecture model to integrate personal health records. J Biomed Inform 2017 Jul;71:70-81 https://www.sciencedirect.com/science/article/pii/S1532046417301089?via%3Dihub Klein DM, Pham K, Samy L, Bluth A, Nazi KM, Witry M, Klutts JS, Grant KM, Gundlapalli AV, Kochersberger G, Pfeiffer L, Romero S, Vetter B, Turvey CL. The veteran-initiated electronic care coordination: a multisite initiative to promote and evaluate consumer-mediated health information exchange. Telemed J E Health 2017 Apr;23(4):264-27 https://www.liebertpub.com/doi/abs/10.1089/tmj.2016.0078?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& Boockvar KS, Ho W, Pruskowski J, DiPalo KE, Wong JJ, Patel J, Nebeker JR, Kaushal R, Hung W. Effect of health information exchange on recognition of medication discrepancies is interrupted when data charges are introduced: results of a cluster-randomized controlled trial. J Am Med Inform Assoc 2017 Nov 1;24(6):1095-101 https://academic.oup.com/jamia/article-abstract/24/6/1095/3826531?redirectedFrom=fulltext Downing NL, Adler-Milstein J, Palma JP, Lane S, Eisenberg M, Sharp C; Northern California HIE Collaborative, Longhurst CA. Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange. J Am Med Inform Assoc 2017 Jan;24(1):113-22 https://academic.oup.com/jamia/article/24/1/113/2631458

scholarly journals Best Paper Selection

2017 ◽  
Vol 26 (01) ◽  
pp. e3-e4
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Point Of Care ◽  
Personal Health Record ◽  
Pediatric Emergency ◽  
Personal Health ◽  
Genomic Information ◽  
Electronic Personal Health Record ◽  
Quasi Experimental

Bahous MC, Shadmi E. Health information exchange and information gaps in referrals to a pediatric emergency department. Int J Med Inform 2016;87:68-74 https://linkinghub.elsevier.com/retrieve/pii/S1386-5056(15)30078-2 Esmaeilzadeh P, Sambasivan M. Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach. J Biomed Inform 2016;64:74-86 http://www.sciencedirect.com/science/article/pii/S1532046416301241?via%3Dihub Massoudi BL, Marcial LH, Tant E, Adler-Milstein J, West SL. Using health information exchanges to calculate clinical quality measures: A study of barriers and facilitators. Healthc (Amst) 2016;4(2):104-8 https://linkinghub.elsevier.com/retrieve/pii/S2213-0764(15)30057-9 Toscos T, Daley C, Heral L, Doshi R, Chen YC, Eckert GJ, Plant RL, Mirro MJ. Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study. J Am Med Inform Assoc 2016;23(1):119-28 https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocv164 Warner JL, Rioth MJ, Mandl KD, Mandel JC, Kreda DA, Kohane IS, Carbone D, Oreto R, Wang L, Zhu S, Yao H, Alterovitz G. SMART precision cancer medicine: a FHIR-based app to provide genomic information at the point of care. J Am Med Inform Assoc 2016;23(4):701-10 https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocw015

scholarly journals Data protection, data management, and data sharing: Stakeholder perspectives on the protection of personal health information in South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260341
Author(s):  
Ciara Staunton ◽  
Kathrina Tschigg ◽  
Gayle Sherman
Keyword(s):  
South Africa ◽  
Health Information ◽  
Data Protection ◽  
Personal Information ◽  
Data Use ◽  
Personal Health Information ◽  
Personal Health ◽  
Structured Interviews ◽  
Laboratory Service ◽  
The Impact

The Protection of Personal Information Act (POPIA) 2013 came into force in South Africa on 1 July 2020. It seeks to strengthen the processing of personal information, including health information. While POPIA is to be welcomed, there are concerns about the impact it will have on the processing of health information. To ensure that the National Health Laboratory Service [NHLS] is compliant with these new strict processing requirements and that compliance does not negatively impact upon its current screening, treatment, surveillance and research mandate, it was decided to consider the development of a NHLS POPIA Code of Conduct for Personal Health. As part of the process of developing such a Code and better understand the challenges faced in the processing of personal health information in South Africa, 19 semi-structured interviews with stakeholders were conducted between June and September 2020. Overall, respondents welcomed the introduction of POPIA. However, they felt that there are tensions between the strengthening of data protection and the use of personal information for individual patient care, treatment programmes, and research. Respondents reported a need to rethink the management of personal health information in South Africa and identified 5 issues needing to be addressed at a national and an institutional level: an understanding of the importance of personal information; an understanding of POPIA and data protection; improve data quality; improve transparency in data use; and improve accountability in data use. The application of POPIA to the processing of personal health information is challenging, complex, and likely costly. However, personal health information must be appropriately managed to ensure the privacy of the data subject is protected, but equally that it is used as a resource in the individual’s and wider public interest.

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 ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Maintenance Organization ◽  
Personal Health Information ◽  
Direct Care ◽  
Intention To Use ◽  
Cross Sectional ◽  
Health Maintenance ◽  
Share Information

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

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