Factors motivating and affecting health information exchange usage

Joshua Vest, Hongwei Zhao, J. Jaspserson, Larry D. Gamm, Robert L. Ohsfeldt

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Objective: Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design: Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements: Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results: The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations: Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions: This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act.

Original languageEnglish (US)
Pages (from-to)143-149
Number of pages7
JournalJournal of the American Medical Informatics Association
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Health Information Systems
Health Information Exchange
Medical Informatics
Information Systems
Hospital Emergency Service
Public Health
Cross-Sectional Studies
Logistic Models
Economics
Health

ASJC Scopus subject areas

  • Health Informatics

Cite this

Factors motivating and affecting health information exchange usage. / Vest, Joshua; Zhao, Hongwei; Jaspserson, J.; Gamm, Larry D.; Ohsfeldt, Robert L.

In: Journal of the American Medical Informatics Association, Vol. 18, No. 2, 01.03.2011, p. 143-149.

Research output: Contribution to journalArticle

Vest, Joshua ; Zhao, Hongwei ; Jaspserson, J. ; Gamm, Larry D. ; Ohsfeldt, Robert L. / Factors motivating and affecting health information exchange usage. In: Journal of the American Medical Informatics Association. 2011 ; Vol. 18, No. 2. pp. 143-149.
@article{cf73b0af421343bdb0b6e6e2658ac197,
title = "Factors motivating and affecting health information exchange usage",
abstract = "Objective: Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design: Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements: Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results: The system was accessed for 2.3{\%} of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations: Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions: This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act.",
author = "Joshua Vest and Hongwei Zhao and J. Jaspserson and Gamm, {Larry D.} and Ohsfeldt, {Robert L.}",
year = "2011",
month = "3",
day = "1",
doi = "10.1136/jamia.2010.004812",
language = "English (US)",
volume = "18",
pages = "143--149",
journal = "Journal of the American Medical Informatics Association : JAMIA",
issn = "1067-5027",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Factors motivating and affecting health information exchange usage

AU - Vest, Joshua

AU - Zhao, Hongwei

AU - Jaspserson, J.

AU - Gamm, Larry D.

AU - Ohsfeldt, Robert L.

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Objective: Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design: Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements: Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results: The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations: Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions: This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act.

AB - Objective: Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design: Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements: Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results: The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations: Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions: This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act.

UR - http://www.scopus.com/inward/record.url?scp=79953121036&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953121036&partnerID=8YFLogxK

U2 - 10.1136/jamia.2010.004812

DO - 10.1136/jamia.2010.004812

M3 - Article

C2 - 21262919

AN - SCOPUS:79953121036

VL - 18

SP - 143

EP - 149

JO - Journal of the American Medical Informatics Association : JAMIA

JF - Journal of the American Medical Informatics Association : JAMIA

SN - 1067-5027

IS - 2

ER -