Appl Clin Inform - Care everywhere, a point-to-point HIE tool: utilization and impact on patient care in the ED.

Tópicos

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Resumo

CKGROUND: Emergency departments (EDs) routinely struggle with gaps in information when providing patient care. A point to point health information exchange (HIE) model has the potential to effectively fill those gaps.OBJECTIVE: To examine the utility, perceived and actual, of a point-to-point HIE tool called Care Everywhere (CE) and its impact on patient care in the ED.METHODS: This mixed methods study was performed at four large hospital EDs between January 2012 and November 2012. Retrospective data was extracted from the electronic health record (EHR) to evaluate CE utilization since implementation. ED notes data were extracted from ED visits occurring between January 2012 and June 2012 and were reviewed to evaluate the impact of exchanged information on patient care.RESULTS: Per focus group discussions, physicians thought the information received via CE was of value to patient care, particularly laboratory results, imaging, medication lists, discharge summaries and ECG interpretations. They feel the greatest impact of HIE is the avoidance of duplicative diagnostic testing and the identification of drug-seeking behavior. Nursing and ancillary staff expressed somewhat less enthusiasm but still felt HIE positively impacted patient care. Over a period of six months, CE was used in approximately 1.46% of ED encounters. A review of ED provider notes over that time period revealed CE use resulted in 560 duplicate diagnostic procedures being avoided and 28 cases of drug seeking behavior identified.CONCLUSION: Our study provides insight into the perceived value of HIE from the point of view of our ED physicians and staff. It also demonstrates that a point-to-point HIE tool such as Epic System's Care Everywhere has the potential to generate greater efficiencies within the ED and impact to patient care through elimination of duplicative diagnostic imaging or testing and resource utilization associated with those procedures.

Resumo Limpo

ckground emerg depart ed routin struggl gap inform provid patient care point point health inform exchang hie model potenti effect fill gapsobject examin util perceiv actual pointtopoint hie tool call care everywher ce impact patient care edmethod mix method studi perform four larg hospit ed januari novemb retrospect data extract electron health record ehr evalu ce util sinc implement ed note data extract ed visit occur januari june review evalu impact exchang inform patient careresult per focus group discuss physician thought inform receiv via ce valu patient care particular laboratori result imag medic list discharg summari ecg interpret feel greatest impact hie avoid duplic diagnost test identif drugseek behavior nurs ancillari staff express somewhat less enthusiasm still felt hie posit impact patient care period six month ce use approxim ed encount review ed provid note time period reveal ce use result duplic diagnost procedur avoid case drug seek behavior identifiedconclus studi provid insight perceiv valu hie point view ed physician staff also demonstr pointtopoint hie tool epic system care everywher potenti generat greater effici within ed impact patient care elimin duplic diagnost imag test resourc util associ procedur

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