J Med Syst - How are health professionals using health information exchange systems? Measuring usage for evaluation and system improvement.

Tópicos

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Resumo

Health information exchange (HIE) is an avenue to improving patient care and an important priority under the Meaningful Use requirements. However, we know very little about the usage of HIE systems. Understanding how healthcare professionals actually utilize HIE systems will provide practical insights to system evaluation, help guide system improvement, and help organizations assess performance. We developed a novel way of describing professionals' HIE usage from the log files of an operational HIE-facilitating organization. The system employed a webpage-style interface. The screen number, types, and variation served to cluster all sessions in to five categories of HIE usage: minimal usage, repetitive searching, clinical information, mixed information, and demographic information. This method reduced the 1,661 different patterns into five recognizable groups for analysis. Overall, most users engaged with the system in a minimal fashion. In terms of user characteristics, minimal usage was highest among physicians and the highest percentage of clinical information usage was among nurses. Usage also differed by organization with repetitive searching most common in settings with scheduled encounters and uncommon in the faster-paced emergency department. Lastly, usage also varied by timing of the patient encounter. Within a single HIE system, discernible types of users behavior existed and varied across jobs, organizations, and time. This approach relied on objective data and can be replicated. In addition, our approach demonstrates that substantial variation in user behaviors exists beyond the more simplistic measures of adoption/non-adoption or access/no-access applied in previous research. This approach can help leaders and evaluators assess their own and other organizations.

Resumo Limpo

health inform exchang hie avenu improv patient care import prioriti meaning use requir howev know littl usag hie system understand healthcar profession actual util hie system will provid practic insight system evalu help guid system improv help organ assess perform develop novel way describ profession hie usag log file oper hiefacilit organ system employ webpagestyl interfac screen number type variat serv cluster session five categori hie usag minim usag repetit search clinic inform mix inform demograph inform method reduc differ pattern five recogniz group analysi overal user engag system minim fashion term user characterist minim usag highest among physician highest percentag clinic inform usag among nurs usag also differ organ repetit search common set schedul encount uncommon fasterpac emerg depart last usag also vari time patient encount within singl hie system discern type user behavior exist vari across job organ time approach reli object data can replic addit approach demonstr substanti variat user behavior exist beyond simplist measur adoptionnonadopt accessnoaccess appli previous research approach can help leader evalu assess organ

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