Frequency of Usage of a Health Information Exchange in (Kierkegaard et al, 2014)


Kierkegaard and colleagues have published an interesting paper in which they investigate Health Information Exchange (HIE) usage with a qualitative study.

One of the themes that they identify is frequency of usage. There were a number of factors which influenced the frequency of usage

  1. Profession. There were a number of professions utilising the HIE. Amongst physicians there were champion users.
  2. Location. The researchers looked at usage in primary care and A&E. Although the usage was higher in both, the usage was higher in primary care considering that information was pushed onto the HIE and pulled from the HIE.

Themes in (Kierkegaard et al, 2014)

The researchers identify the following 8 themes in Table 4.

  • Purpose of Usage
  • Frequency of Usage
  • Availability of Information
  • Patient Consent
  • Healthcare Organisation Participation
  • Non-RHIO Related Exchange Mechanisms
  • Search Confidence
  • Usability


Patient Records

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.


How could Health Information Exchange Better Meet the Needs of Care Practitioners?
P. Kierkegaard, R. Kaushal, J.R. Vest. Appl Clin Inform. 2014; 5(4): 861–877. Published online 2014 Oct 15. doi: 10.4338/ACI-2014-06-RA-0055

Links to Other Posts in the Health Information Exchange Series

General Posts to Date on Health Information Exchanges

Posts on Examples of Health Information Exchanges

SNOMED CT®/ICD Mapping and Harmonisation Posts


ICD 1-10 Posts

ICD-11 Posts

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Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section


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