Electronic Exchange of Poisoning Information

描述（由申请人提供）：意外中毒是美国伤害死亡的第二大原因。中毒控制中心（PCC）和急救部门（ED）之间的协作依赖于口头和电话沟通，这可能导致沟通不畅、数据丢失和错误。（3，4）。最近的研究发现，目前基于电话的协作系统存在许多漏洞和效率低下的问题，必须解决这些漏洞，以确保患者安全。健康信息交换（HIE），病人信息的电子交换，可以更好地支持PCC-ED合作中毒病人在日常操作和灾难情况下，当基于电话的通信是脆弱的。然而，我们目前缺乏PCC-ED健康信息交换的过程模型和信息学工具（标准和软件），这对资源有限的美国毒物控制中心的HIE构成了重大障碍。此外，没有关于实施这种类型的提供者对提供者健康信息交换的临床效果的可用信息，包括对工作流程和患者护理的影响。本研究的具体目标如下：（1）开发HIE支持的艾德- PCC协作的模型过程，（2）开发和实施HIE支持的ED-PCC协作的信息学工具，（3）评估模型HIE过程和信息学工具对工作流程、沟通、效率和利用的影响。我们将为ED-PCC健康信息交换开发一个可复制、可扩展的过程，并开发信息学工具，使急诊科和中毒控制中心能够参与HIE。我们还将评估原型信息交换流程对工作流程和临床结局的影响，包括急诊室上门决策时间、PCC病例关闭时间以及ED和PCC之间交换的电话数量变化。这些创新反映了以患者为中心的信息管理，旨在确保中毒相关信息的可用性，以支持护理中的过渡和协作。!

DESCRIPTION (provided by applicant): Unintentional poisoning is the second leading cause of injury death in the United States. Collaboration between poison control centers (PCCs) and emergency departments (EDs) is dependent upon verbal, telephone communication that can lead to miscommunication, data loss, and error. (3, 4). Recent research has identified numerous vulnerabilities and inefficiencies in the current telephone-based system of collaboration, vulnerabilities that must be addressed in order to ensure patient safety. Health information exchange (HIE), the electronic exchange of patient information, could better support PCC-ED collaboration for poisoned patients during routine operations and in disaster scenarios, when telephone-based communication is fragile. However, we currently lack both process models and informatics tools (standards and software) for PCC-ED health information exchange and this poses a substantial barrier to HIE for U.S. poison control centers operating with limited resources. Moreover, there is no available information on the clinical effects of implementing this type of provider-to-provider health information exchange, including effects on workflow and patient care. The specific aims of this study are as follows: (1) Develop a model process for HIE supported ED- PCC collaboration, (2) Develop and implement informatics tools for HIE supported ED-PCC collaboration, and (3) Evaluate the effects of the model HIE process and informatics tools on workflow, communication, efficiency, and utilization. We will develop a replicable, scalable process for ED-PCC health information exchange and develop informatics tools that enable emergency departments and poison control centers to engage in HIE. We will also evaluate the effect of the prototype information exchange process on workflow and clinical outcomes including emergency department door-to-decision time, time to PCC case closure, and change in the number of telephone calls exchanged between EDs and PCCs. These innovations reflect patient-focused information management and are designed to ensure availability of poisoning-related information to support transitions and collaborations in care. !