BMC Med Inform Decis Mak - Use of a health information exchange system in the emergency care of children.

Tópicos

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{ activ(1452) weight(1219) physic(1104) }
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Resumo

CKGROUND: Children may benefit greatly in terms of safety and care coordination from the information sharing promised by health information exchange (HIE). While information exchange capability is a required feature of the certified electronic health record, we known little regarding how this technology is used in general and for pediatric patients specifically.METHODS: Using data from an operational HIE effort in central Texas, we examined the factors associated with actual system usage. The clinical and demographic characteristics of pediatric ED encounters (n = 179,445) were linked to the HIE system user logs. Based on the patterns of HIE system screens accessed by users, we classified each encounter as: no system usage, basic system usage, or novel system usage. Using crossed random effects logistic regression, we modeled the factors associated with basic and novel system usage.RESULTS: Users accessed the system for 8.7% of encounters. Increasing patient comorbidity was associated with a 5% higher odds of basic usage and 15% higher odds for novel usage. The odds of basic system usage were lower in the face of time constraints and for patients who had not been to that location in the previous 12 months.CONCLUSIONS: HIE systems may be a source to fulfill users' information needs about complex patients. However, time constraints may be a barrier to usage. In addition, results suggest HIE is more likely to be useful to pediatric patients visiting ED repeatedly. This study helps fill an existing gap in the study of technological applications in the care of children and improves knowledge about how HIE systems are utilized.

Resumo Limpo

ckground children may benefit great term safeti care coordin inform share promis health inform exchang hie inform exchang capabl requir featur certifi electron health record known littl regard technolog use general pediatr patient specificallymethod use data oper hie effort central texa examin factor associ actual system usag clinic demograph characterist pediatr ed encount n link hie system user log base pattern hie system screen access user classifi encount system usag basic system usag novel system usag use cross random effect logist regress model factor associ basic novel system usageresult user access system encount increas patient comorbid associ higher odd basic usag higher odd novel usag odd basic system usag lower face time constraint patient locat previous monthsconclus hie system may sourc fulfil user inform need complex patient howev time constraint may barrier usag addit result suggest hie like use pediatr patient visit ed repeat studi help fill exist gap studi technolog applic care children improv knowledg hie system util

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