Int J Med Inform - Health information exchange system usage patterns in three communities: practice sites, users, patients, and data.

Tópicos

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Resumo

JECTIVES: Public and private organizations are implementing systems for query-based health information exchange (HIE), the electronic aggregation of patient data from multiple institutions. However, existing studies of query-based HIE system usage have addressed a limited number of settings. Our goal was to quantify the breadth and depth of usage of a query-based HIE system implemented across multiple communities with diverse care settings and patient populations.METHODS: We performed a cross-sectional study in three communities in New York State using system access log files from January 2009 to May 2011 to measure usage patterns of a query-based HIE web portal system with respect to practice sites, users, patients, and data.RESULTS: System access occurred from 60% (n=200) of practice sites registered to use the system in Community A, 59% (n=156) in Community B, and 82% (n=28) in Community C. In Communities A and B, users were primarily non-clinical staff in outpatient settings, while in Community C inpatient physicians were the main users. Across communities, proportions of patients whose data were accessed varied with 5% (n=11,263) in Community A, 60% (n=212,586) in Community B, and 1% (n=1107) in Community C. In Community B, users updated patient consent through the HIE portal, whereas in the other communities, users updated patient consent through a separate system. Across communities, users most frequently accessed only patient summary data displayed by default followed by detailed laboratory and radiology data.CONCLUSIONS: This study is among the first to illustrate large-scale usage of a query-based HIE system implemented across multiple communities. Patient summary data displayed by default may be an important feature of query-based HIE systems. User role, practice site type, and patient consent workflow may affect patterns of query-based HIE web portal system usage in the communities studied and elsewhere.

Resumo Limpo

jectiv public privat organ implement system querybas health inform exchang hie electron aggreg patient data multipl institut howev exist studi querybas hie system usag address limit number set goal quantifi breadth depth usag querybas hie system implement across multipl communiti divers care set patient populationsmethod perform crosssect studi three communiti new york state use system access log file januari may measur usag pattern querybas hie web portal system respect practic site user patient dataresult system access occur n practic site regist use system communiti n communiti b n communiti c communiti b user primarili nonclin staff outpati set communiti c inpati physician main user across communiti proport patient whose data access vari n communiti n communiti b n communiti c communiti b user updat patient consent hie portal wherea communiti user updat patient consent separ system across communiti user frequent access patient summari data display default follow detail laboratori radiolog dataconclus studi among first illustr largescal usag querybas hie system implement across multipl communiti patient summari data display default may import featur querybas hie system user role practic site type patient consent workflow may affect pattern querybas hie web portal system usag communiti studi elsewher

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