Exploring the Utilization of and Outcomes from Health Information Exchange in Emergency Settings

项目摘要 卫生信息交换(HIE)涉及临床或行政管理的电子交换 跨医疗保健机构、健康数据存储库和 各州。广泛的HIE有可能改善卫生保健，HIE已被描述 作为最近医疗改革举措的关键组成部分，包括基于价值的护理和患者 以医疗院为中心。尽管有潜力，但HIE的证据基础薄弱。其他内容 使用可靠方法的研究是必要的，以加强证据基础并使 在使用HIE的各种环境中检查HIE。该计划的目的是 建议的研究是使用纵向日志检查急诊科工作人员中HIE的使用情况 来自HIE运作网络的文件，涉及数十家医院。具体目标集中在： 1)描述跨多个组织的HIE使用模式；2)采访紧急情况 科室工作人员关于在病人护理中使用HIE的促进者和障碍； 以及3)评估HIE的使用和结果之间的关系(例如，入学、实验室 测试)随时间推移。从拟议研究中获得的知识将提供证据或 反对使用HIE。此外，这项研究将创建可推广的方法和 理解HIE使用和使用对卫生保健提供的影响的理论框架 以及临床和人口健康结果。

Project Summary Health information exchange (HIE) involves the electronic exchange of clinical or administrative health data across the boundaries of health care institutions, health data repositories, and states. Widespread HIE has the potential to improve health care, and HIE has been described as a critical component of recent health reform initiatives including value-based care and patient centered medical homes. Despite its potential, the evidence base for HIE is weak. Additional studies employing robust methods are necessary to strengthen the evidence base and enable examination of HIE across the myriad environments in which it is used. The purpose of the proposed study is to examine HIE use among emergency department staff using longitudinal log files from an operational HIE network involving dozens of hospitals. The specific aims focus on: 1) characterizing HIE usage patterns across multiple organizations; 2) interviewing emergency department staff about the facilitators and barriers to using HIE in the context of patient care; and 3) evaluating the relationship between HIE use and outcomes (e.g., admissions, laboratory testing) over time. Knowledge gained from the proposed study will provide evidence for or against the use of HIE. Furthermore, the research will create generalizable methods and a theoretical framework for understanding HIE use and the impact of use on health care delivery as well as clinical and population health outcomes.