Health information exchange usage in emergency departments and clinics

The who, what, and why

Kevin B. Johnson, Kim M. Unertl, Qingxia Chen, Nancy M. Lorenzi, Hui Nian, James Bailey, Mark Frisse

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Objective: Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE. Design: We used a mixed-method analysis, consisting of cross-sectional audit log data, semi-structured interviews, and direct observation in a sample of emergency departments and ambulatory safety net clinics actively using HIE. For each site, we measured overall usage trends, user logon statistics, and data types accessed by users. We also assessed reasons for use and outcomes of use. Results: Overall, users accessed HIE for 6.8% of all encounters, with higher rates of access for repeat visits, for patients with comorbidities, for patients known to have data in the exchange, and at sites providing HIE access to both nurses and physicians. Discharge summaries and test reports were the most frequently accessed data in the exchange. Providers consistently noted retrieving additional history, preventing repeat tests, comparing new results to retrieved results, and avoiding hospitalizations as a consequence of HIE access. Conclusion: HIE use in emergency departments and ambulatory clinics was focused on patients where missing information was believed to be present in the exchange and was related to factors including the roles of people with access, the setting, and other sitespecific issues that impacted the overall breadth of routine system use. These data should form an important foundation as other sites embark upon HIE implementation.

Original languageEnglish (US)
Pages (from-to)690-697
Number of pages8
JournalJournal of the American Medical Informatics Association
Volume18
Issue number5
DOIs
StatePublished - Sep 1 2011

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Hospital Emergency Service
Safety-net Providers
Health Information Systems
Health Information Exchange
Developed Countries
Comorbidity
Hospitalization
Cross-Sectional Studies
History
Nurses
Observation
Interviews
Physicians

All Science Journal Classification (ASJC) codes

  • Health Informatics

Cite this

Health information exchange usage in emergency departments and clinics : The who, what, and why. / Johnson, Kevin B.; Unertl, Kim M.; Chen, Qingxia; Lorenzi, Nancy M.; Nian, Hui; Bailey, James; Frisse, Mark.

In: Journal of the American Medical Informatics Association, Vol. 18, No. 5, 01.09.2011, p. 690-697.

Research output: Contribution to journalArticle

Johnson, Kevin B. ; Unertl, Kim M. ; Chen, Qingxia ; Lorenzi, Nancy M. ; Nian, Hui ; Bailey, James ; Frisse, Mark. / Health information exchange usage in emergency departments and clinics : The who, what, and why. In: Journal of the American Medical Informatics Association. 2011 ; Vol. 18, No. 5. pp. 690-697.
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