Health Information Exchange in Memphis: Impact on the Physician-Patient Relationship
ABSTRACT Health information exchanges represent one way of making medical information available to practitioners across institutional boundaries. One health information exchange in Memphis Tennessee has been operational since May of 2006 and provides information supporting care for over 1.2 million individuals. Creating such an exchange challenged traditional institutional boundaries, roles, and perceptions. Approaching these challenges required leadership, trust, sound policy, new forms of dialogue, and an incremental approach to technology. Early evidence suggests a positive impact on patient care and a change in the way providers interact with their patients and on another. Personal health records, consolidated EHR systems, and other alternative models promise to have similar impacts on the way in which providers and patients interact with one another.
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ABSTRACT: Health information exchange (HIE) is the interorganizational sharing of patient information and is one of many health information technology initiatives expected to transform the U.S. healthcare system. Two outcomes expected to be improved by HIE are patient-provider communication and patient satisfaction . This analysis examined the relationship between the level of HIE engagement and these two factors in a sample of U.S. hospitals. Independent variables came from existing secondary sources and the dependent measures were from the Hospital Consumer Assessment of Healthcare Providers and Systems. The analysis included 3,278 hospitals. Using ordinary least squares regression, implemented HIE was positively associated with the percentage of patients reporting nurses communicated well and higher satisfaction. Due to the potential for selection bias, results were further explored using a propensity score analysis. Hospitals that had adopted HIE, but not yet implemented saw no benefits. Hospitals' level of HIE was not associated with the percentage of patients reporting doctors communicated well. According to propensity score corrected estimates, implemented HIE was associated with the percentage of patients who reported nurses always communicated well and who would definitely recommend the hospital. Few studies have examined the impact of HIE at the organizational level. This examination provides some evidence that hospitals engaging in HIE are associated with higher patient satisfaction.Applied Clinical Informatics 01/2011; 2(4):447-59. DOI:10.4338/ACI-2011-06-RA-0040 · 0.39 Impact Factor
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ABSTRACT: Louisiana is severely affected by HIV/AIDS, ranking fifth in AIDS rates in the USA. The Louisiana Public Health Information Exchange (LaPHIE) is a novel, secure bi-directional public health information exchange, linking statewide public health surveillance data with electronic medical record data. LaPHIE alerts medical providers when individuals with HIV/AIDS who have not received HIV care for >12 months are seen at any ambulatory or inpatient facility in an integrated delivery network. Between 2/1/2009 and 1/31/2011, 488 alerts identified 345 HIV positive patients. Of those identified, 82% had at least one CD4 or HIV viral load test over the study follow-up period. LaPHIE is an innovative use of health information exchange based on surveillance data and real time clinical messaging, facilitating rapid provider notification of those in need of treatment. LaPHIE successfully reduces critical missed opportunities to intervene with individuals not in care, leveraging information historically collected solely for public health purposes, not health care delivery, to improve public health.Journal of the American Medical Informatics Association 10/2011; 19(3):448-52. DOI:10.1136/amiajnl-2011-000412 · 3.50 Impact Factor
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ABSTRACT: Health information exchange (HIE) is a key component of health care reform that enables clinical data sharing between providers, patients, and health care organizations. The value of HIE rests in the promise that more efficient and effective access to clinical data will improve patients’ condition-specific outcomes relative to the costs. For example, improvements in outcomes may result from fewer medical errors and improved adherence to evidence-based recommendations, whereas reductions in costs may result from fewer duplicate tests and improved care coordination. However, even though health care reform efforts promote HIE as a way to improve care and curb costs, few studies demonstrate these results. We have organized the available evidence at national and regional levels to report on costs and benefits associated with HIE, and identify potential areas of future research.Journal of Healthcare Leadership 04/2012; DOI:10.2147/JHL.S16438