Kierkegaard and colleagues have published an interesting paper in which they investigate Health Information Exchange usage with a qualitative study. One of the themes they identified is search confidence.
The researchers quote participants who state that finding the right information is a key driver in the use of a HIE. The researchers suggest that physicians typically use the HIE three or four times before making a decision. However what is interesting is that elsewhere in the paper the researchers report that the frequency of usage depends on the background of the user.
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
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
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