J Med Syst - Challenges, alternatives, and paths to sustainability for health information exchange efforts.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ cost(1906) reduc(1198) effect(832) }
{ system(1050) medic(1026) inform(1018) }
{ research(1085) discuss(1038) issu(1018) }
{ research(1218) medic(880) student(794) }
{ method(1557) propos(1049) approach(1037) }
{ care(1570) inform(1187) nurs(1089) }
{ model(2341) predict(2261) use(1141) }
{ health(3367) inform(1360) care(1135) }
{ state(1844) use(1261) util(961) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
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{ activ(1452) weight(1219) physic(1104) }
{ system(1976) rule(880) can(841) }
{ problem(2511) optim(1539) algorithm(950) }
{ algorithm(1844) comput(1787) effici(935) }
{ control(1307) perform(991) simul(935) }
{ howev(809) still(633) remain(590) }
{ studi(1119) effect(1106) posit(819) }
{ data(2317) use(1299) case(1017) }
{ analysi(2126) use(1163) compon(1037) }
{ method(1969) cluster(1462) data(1082) }
{ model(3404) distribut(989) bayesian(671) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ motion(1329) object(1292) video(1091) }
{ data(1714) softwar(1251) tool(1186) }
{ data(3963) clinic(1234) research(1004) }
{ import(1318) role(1303) understand(862) }
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{ activ(1138) subject(705) human(624) }
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{ health(1844) social(1437) communiti(874) }
{ use(1733) differ(960) four(931) }
{ result(1111) use(1088) new(759) }
{ decis(3086) make(1611) patient(1517) }
{ method(2212) result(1239) propos(1039) }
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{ imag(1057) registr(996) error(939) }
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{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
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{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ extract(1171) text(1153) clinic(932) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ case(1353) use(1143) diagnosi(1136) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ model(2656) set(1616) predict(1553) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

Health information exchange (HIE) is a promising approach to improving the cost and quality of healthcare. We sought to identify the strengths and weaknesses of organizational models to achieve exchange, and what can be done to ensure the sustainability and effectiveness of exchange efforts. We interviewed state and national health informatics policy experts (n=17). Data were collected as part of an evaluation of the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) program and included respondents from both the private and public sectors. Data were analyzed using a general inductive and comparative approach with open coding of themes. Interviewees generally viewed HIE as a public or societal good to be valued. However, they identified challenges with the regional health information organization (RHIO) model of facilitating exchange including: economics, organizational issues, and geography. RHIOs were contrasted against alternative methods of exchange such as Direct, enterprise HIE, and vendor-mediated exchange. HIE is a difficult undertaking due to political and economic reasons. Alternatives to the RHIO model have features that may be more attractive to participants, but may be of less public benefit. Using states as intermediaries and mandating exchange under public health law may avoid the challenges facing exchange efforts. Moving forward, policies will have to address the shortcomings of each HIE model to ensure information is effectively shared between providers to maximize health benefits.

Resumo Limpo

health inform exchang hie promis approach improv cost qualiti healthcar sought identifi strength weak organiz model achiev exchang can done ensur sustain effect exchang effort interview state nation health informat polici expert n data collect part evalu health care effici afford law new yorker heal ny program includ respond privat public sector data analyz use general induct compar approach open code theme interviewe general view hie public societ good valu howev identifi challeng region health inform organ rhio model facilit exchang includ econom organiz issu geographi rhio contrast altern method exchang direct enterpris hie vendormedi exchang hie difficult undertak due polit econom reason altern rhio model featur may attract particip may less public benefit use state intermediari mandat exchang public health law may avoid challeng face exchang effort move forward polici will address shortcom hie model ensur inform effect share provid maxim health benefit

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