Use of a health information exchange system in the emergency care of children

Joshua Vest, Jon Jasperson, Hongwei Zhao, Larry D. Gamm, Robert L. Ohsfeldt

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: 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.

Original languageEnglish (US)
Article number78
JournalBMC Medical Informatics and Decision Making
Volume11
Issue number1
DOIs
StatePublished - Dec 1 2011
Externally publishedYes

Fingerprint

Health Information Systems
Emergency Medical Services
Pediatrics
Information Dissemination
Electronic Health Records
Child Care
Health Information Exchange
Comorbidity
Logistic Models
Demography
Technology
Safety

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

Cite this

Use of a health information exchange system in the emergency care of children. / Vest, Joshua; Jasperson, Jon; Zhao, Hongwei; Gamm, Larry D.; Ohsfeldt, Robert L.

In: BMC Medical Informatics and Decision Making, Vol. 11, No. 1, 78, 01.12.2011.

Research output: Contribution to journalArticle

Vest, Joshua ; Jasperson, Jon ; Zhao, Hongwei ; Gamm, Larry D. ; Ohsfeldt, Robert L. / Use of a health information exchange system in the emergency care of children. In: BMC Medical Informatics and Decision Making. 2011 ; Vol. 11, No. 1.
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