J Am Med Inform Assoc - Sociotechnical challenges to developing technologies for patient access to health information exchange data.

Tópicos

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Resumo

CKGROUND: Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations.OBJECTIVE: To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data.METHODS: Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework.RESULTS: As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans.CONCLUSIONS: This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors.

Resumo Limpo

ckground provid patient access medic data wide expect help educ empow manag health health inform exchang hie infrastructur potenti help patient access record across multipl healthcar provid studi three hie organ develop portal give consum access hie data previous exchang among healthcar organizationsobject follow develop new consum portal technolog identifi barrier facilit patient access hie datamethod semistructur interview key inform year period span develop earli implement three new project code accord sociotechn frameworkresult organ tri develop function fulli serv need provid patient plan alter technic barrier primarili relat data standard cultur legal issu surround data access organiz chang also play import role alter project plan three case patient access data signific scale back initi plansconclus prospect studi reveal sociotechn factor previous identifi import health inform technolog success failur help shape evolut three novel consum informat project barrier provid patient seamless access hie data multifactori remedi will address technic organiz cultur factor

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