Evaluation of the Impact of Health Information Exchange on Emergency Medicine

描述(由申请人提供)： 全国各地正在开发基于计算机的卫生信息交换项目，以提高提供卫生保健的安全性、质量和效率，并按照乔治·W·布什总统和卫生与公众服务部的要求，建立一个全国性的卫生信息网络(NHIN)。尽管预计不同提供商之间的临床数据电子交换将改善临床护理，但很少有直接数据显示其有效性。本文介绍的项目旨在评估HIE项目对纽约大都市区提供的临床护理的质量、安全性和成本的影响。对HIE在这个多样化和人口稠密的地区的益处进行评估，将是朝着建立一个讨论和支持使用HIE的知识体系迈出的重要一步。 拟议的评估计划背后的具体假设是，在纽约大都市区实施以计算机为基础的HIE网络将提高质量和安全性，降低医疗保健提供成本，同时满足提供者的高度满意度。这一假设基于以下观察结果。首先，临床医生在床边的信息差距可能会导致差错，并降低他们提供的医疗保健的质量和安全性，而这些差距将通过HIE得到显著改善。其次，在有限的情况下，通过HIE访问临床数据已被证明可以提高效率和节省资金，如果在全国范围内实施，预计每年将节省数十亿美元。第三，纽约大都会地区的急诊医生对基于计算机的HIE有明显的需求，因此在该地区的实施可能会引起高度的用户满意度。 这项研究的具体目的是： 1.评估在纽约大都市区的十个急救部门实施的HIE应用程序对质量和安全的影响。 2.从提供者和付款人的角度评估在纽约大都市区十个急救部门实施的HIE应用程序的投资回报。 3.评估提供者对纽约大都市区十个急诊科HIE应用程序的满意度。

DESCRIPTION (provided by applicant): Computer-based health information exchange (HIE) projects are being developed throughout the country to improve the safety, quality and efficiency with which health care is delivered, and to create the building blocks of a nationwide health information network (NHIN) as called for by President George W. Bush and the Department of Health and Human Services. Although it is expected that the electronic exchange of clinical data among disparate providers will improve clinical care, there are few direct data showing its utility. The project described here seeks to evaluate the impact of an HIE project on the quality, safety and cost of clinical care provided in New York metropolitan area. An evaluation showing the benefits of HIE in this diverse and densely populated region would be a significant step toward building a body of knowledge that discusses and supports the use of HIE. The specific hypothesis behind the proposed evaluation plan is that the implementation of a computerbased HIE network in the New York metropolitan area will improve the quality and safety and decrease the cost of health care delivery, while being met with a high degree of provider satisfaction. This hypothesis is based on the following observations. First, information gaps exist for clinicians at the bedside that likely lead to errors and a reduction in the quality and safety of the health care they deliver, and these gaps would be significantly improved by HIE. Second, in limited instances access to clinical data through HIE has been shown to increase efficiency and save money, and is projected to save billions of dollars annually if implemented nationwide. Third, there is a perceived need among emergency physicians in the New York metropolitan area for computer-based HIE and therefore an implementation in this region is likely to elicit a high degree of user satisfaction. The specific aims of this study are to: 1. Evaluate the impact on quality and safety of an HIE application implemented in ten emergency departments in the New York metropolitan area. 2. Evaluate the return on investment for an HIE application implemented in ten emergency departments in the New York metropolitan area from the perspectives of both providers and payers. 3. Evaluate provider satisfaction with the HIE application in ten emergency departments in the New York metropolitan area.