Esmaeilzadeh and Sambasivan write about the types of recipients for information from a Health Information Exchange.
- Recipients who will be utilising information for clinical care. This is perceived as a more favoured option.
- Health Insurance – the authors cite research suggesting that recipients receiving information for health insurance purposes is perceived as a less popular option than for direct clinical care. These studies will also be country specific given international differences in funding of health care.
- Research – this is less popular than direct clinical care in the research cited by the authors. However they also cite research showing that patients are more willing to share information for this purpose after consultation.
- Marketing – this is less popular than direct clinical care in the research cited by the authors
- Health providers sharing information via HIE’s are perceived as more favourable than commercial enterprises offering Patient Health Records (PHR).
- Non-treating physicians – there is less willingness to share information with non-treating physicians than those involved in direct care
- Other uses – there is willingness to temporarily share limited information with government agencies and other physicians based on need
What were the main findings in the Esmaeilzadeh and Sambasivan paper?
Esmaeilzadeh and Sambasivan have published a paper on Health Information Exchanges, ‘Patients’ support for health information exchange: a literature review and classification of key factors‘.
They identified seven key themes from the literature
- Perceived benefits
- Perceived concerns
- Patient characteristics
- Level of patient participation in HIE
- Types of health information to be exchanged
- Types of recipients
- Patient preferences regarding consent
Patient records are central to the delivery of healthcare and serve a number of functions including the recording of clinical assessments and interventions. Aggregated data is also utilised at a local and national level to inform commissioning.
Electronic Patient Records
The digitisation of patient records offers a number of advantages over paper based records. These advantages include automated backup of records, reduced use of physical storage space (since paper based notes are switched to servers), off-site access to records using mobile devices and the potential to develop analytical clinical support tools which use computers to process clinical data to help improve clinical decisions. Not all healthcare services have electronic patient records but most providers are moving in this direction.
Getting Electronic Patient Records to Talk to Each Other
When patients move between healthcare providers – for instance between primary care and the hospital – they may find that one provider does not have information that the other provider has. There are many providers and many electronic paper record systems. For two systems to talk to each other they have to solve a number of problems. When these problems are solved a patient can move between providers and healthcare information can be accessed by the different providers. A key solution to this problem of health information gaps is the Health Information Exchange (HIE).
The Health Information Exchange
There are many definitions of what a Health Information Exchange is. (Hersh et al, 2015) define a HIE as follows:
‘Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations’
Whilst this definition is simple, the process of sharing clinical information between healthcare organisations is technically complex and encompasses a range of software, hardware and governance issues. The process of helping systems to talk to each other is helped by the development of standards. A set of standards is outlined in the NHS interoperability framework.
Links to Other Posts in the Health Information Exchange Series
Esmaeilzadeh P, Sambasivan M.BMC Med Inform Decis Mak. 2017 Apr 4;17(1):33. doi: 10.1186/s12911-017-0436-2. Patients’ support for health information exchange: a literature review and classification of key factors.
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