Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange.
Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange.
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DOI：
10.1093/jamia/ocw063
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Longhurst CA
中科院分区：
文献类型：
--
作者：
Downing NL;Adler-Milstein J;Palma JP;Lane S;Eisenberg M;Sharp C;Northern California HIE Collaborative;Longhurst CA
背景：提供者组织越来越有能力以电子方式交换患者的健康信息。组织卫生信息交换(HIE)政策决策可以影响提供者容易获得外部信息的程度，但这种关系尚未得到很好的研究。目的：我们的目标是检查跨组织的患者健康信息的电子交换与组织HIE决策之间的关系。我们专注于两个关键决策：是否自动搜索来自其他组织的信息，以及是否需要HIE特定患者的同意。方法：对自动查询和患者同意要求对每月交换的临床总结数量的影响进行时间序列回顾分析。我们无法评估摘要、组织决策过程的使用程度或有用性，或对其他供应商的概括性。结果：2013-2015年间，11个组织的临床摘要交换量增长了1349%。11个系统中有9个设置为启用自动查询，自动查询与每月汇率的显著增加相关(P = .006表示趋势变化)。在11个组织中，有7个组织没有专门为HIE要求患者同意，而且这些组织与需要患者同意的组织相比，随着时间的推移，交换量增加得更多。结论：自动查询和有限同意要求是组织HIE政策决策，会影响交换量，并最终影响提供者可用来支持最佳护理的信息。为确保HIE的有效性，未来的努力可能需要明确解决这些因素。
Background: Provider organizations increasingly have the ability to exchange patient health information electronically. Organizational health information exchange (HIE) policy decisions can impact the extent to which external information is readily available to providers, but this relationship has not been well studied. Objective: Our objective was to examine the relationship between electronic exchange of patient health information across organizations and organizational HIE policy decisions. We focused on 2 key decisions: whether to automatically search for information from other organizations and whether to require HIE-specific patient consent. Methods: We conducted a retrospective time series analysis of the effect of automatic querying and the patient consent requirement on the monthly volume of clinical summaries exchanged. We could not assess degree of use or usefulness of summaries, organizational decision-making processes, or generalizability to other vendors. Results: Between 2013 and 2015, clinical summary exchange volume increased by 1349% across 11 organizations. Nine of the 11 systems were set up to enable auto-querying, and auto-querying was associated with a significant increase in the monthly rate of exchange (P = .006 for change in trend). Seven of the 11 organizations did not require patient consent specifically for HIE, and these organizations experienced a greater increase in volume of exchange over time compared to organizations that required consent. Conclusions: Automatic querying and limited consent requirements are organizational HIE policy decisions that impact the volume of exchange, and ultimately the information available to providers to support optimal care. Future efforts to ensure effective HIE may need to explicitly address these factors.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
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通讯作者：
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影响因子：
9.7
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作者：
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DOI：
10.1136/amiajnl-2011-000308
发表时间：
2011-09-01
影响因子：
6.4
作者：
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通讯作者：
Frisse, Mark
影响因子：
3
作者：
Lammers, Eric J.;Adler-Milstein, Julia;Kocher, Keith E.
通讯作者：
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