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（PCCs）和急诊科（EDs）之间的协作依赖于口头和电话沟通，这可能导致沟通不端、数据丢失和错误。(3、4)。最近的研究已经确定了当前基于电话的协作系统中的许多漏洞和低效率，必须解决这些漏洞以确保患者安全。健康信息交换（HIE），即患者信息的电子交换，可以在常规手术和灾难情况下，在基于电话的通信脆弱的情况下，更好地支持中毒患者的PCC-ED协作。然而，我们目前缺乏用于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构成了实质性障碍。此外，目前还没有关于实施这种提供者对提供者健康信息交换的临床效果的信息，包括对工作流程和患者护理的影响。本研究的具体目的如下：(1)建立HIE支持ED-PCC协同的模型流程；(2)开发和实施HIE支持ED-PCC协同的信息学工具；(3)评估模型HIE流程和信息学工具在工作流程、沟通、效率和利用率方面的影响。我们将开发一个可复制的、可扩展的ED-PCC健康信息交换流程，并开发信息学工具，使急诊部门和中毒控制中心能够参与HIE。我们还将评估原型信息交换过程对工作流程和临床结果的影响，包括急诊科从门口到决策时间、到PCC结案时间以及急诊科和PCC之间交换电话次数的变化。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合作。！

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. !