Physician attitudes toward health information exchange: results of a statewide survey (original) (raw)
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Physicians' potential use and preferences related to health information exchange
International Journal of Medical Informatics, 2011
Computerized medical records Electronic health records Medical record linkage/*methods a b s t r a c t Purpose: To characterize physician attitudes and preferences towards health information exchange (HIE), which is the ability to transmit health information electronically across institutions, and identify factors that influence physicians' interest in using HIE for their clinical work.
Healthcare Consumers’ Attitudes Towards Physician and Personal Use of Health Information Exchange
Journal of General Internal Medicine
BACKGROUND Health information exchange (HIE), the electronic transmission of patient medical information across healthcare institutions, is on the forefront of the national agenda for healthcare reform. As healthcare consumers are critical participants in HIE, understanding their attitudes toward HIE is essential. OBJECTIVE To determine healthcare consumers’ attitudes toward physician and personal use of HIE, and factors associated with their attitudes. DESIGN Cross-sectional telephone survey. PARTICIPANTS English-speaking residents of the Hudson Valley of New York. MAIN MEASURE Consumer reported attitudes towards HIE. KEY RESULTS Of 199 eligible residents contacted, 170 (85%) completed the survey: 67% supported physician HIE use and 58% reported interest in using HIE themselves. Multivariate analysis suggested supporters of physician HIE were more likely to be caregivers for chronically ill individuals (OR 4.6, 95% CI 1.06, 19.6), earn more than $100,000 yearly (OR 3.5, 95% CI 1.2, 10.0), and believe physician HIE would improve the privacy and security of their medical records (OR 2.9, 95% CI 1.05, 7.9). Respondents interested in using personal HIE were less likely to be female (OR 0.4, 95% CI 0.1, 0.98), and more likely to be frequent Internet-users (OR 3.3, 95% CI 1.03, 10.6), feel communication among their physicians was inadequate (OR 6.7, 95% CI 1.7, 25.3), and believe personal HIE use would improve communication with their physicians (OR 4.7, 95% CI 1.7, 12.8). CONCLUSIONS Consumer outreach to gain further support for ongoing personal and physician HIE efforts is needed and should address consumer security concerns and potential disparities in HIE acceptance and use.
Information Systems Frontiers
To date, most HIE studies have investigated user perceptions of value prior to use. Few studies have assessed factors associated with the value of HIE through its actual use. This study investigates provider perceptions on HIE comparing those who had prior experience vs those who had no experience with it. In so doing, we identify six constructs: prior use, system complexity, system concerns, public/population health, care delivery, and provider performance. This study uses a mixed methods approach to data collection. From 15 interviews of medical community leaders, a survey was constructed and administered to 263 clinicians. Descriptive statistics and analysis of variance was used, along with Tukey HSD tests for multiple comparisons. Results indicated providers whom previously used HIE had more positive perceptions about its benefits in terms of system complexity (p = .001), care delivery (p = .000), population health (p = .003), and provider performance (p = .005); women providers were more positive in terms of system concerns (p = .000); patient care (p = .031), and population health (p = .009); providers age 44-55 were more positive than older and younger groups in terms of patient care (p = .032), population health (p = .021), and provider performance (p = .014); while differences also existed across professional license groups (physician, nurse, other license, admin (no license)) for all five constructs (p < .05); and type of organization setting (hospital, ambulatory clinic, medical office, other) for three constructs including system concerns (p = .017), population health (p = .018), and provider performance (p = .018). There were no statistically significant differences found between groups based on a provider's role in an organization (patient care, administration, teaching/research, other). Different provider perspectives about the value derived from HIE use exist depending on prior experience with HIE, age, gender, license (physician, nurse, other license, admin (no license)), and type of organization setting (hospital, ambulatory clinic, medical office, other). This study draws from the theory of planned behavior to understand factors related to physicians' perceptions about HIE value, serving as a departure point for more detailed investigations of provider perceptions and behavior in regard to future HIE use and promoting interoperability.
Physicians' opinions of a health information exchange
Journal of the American Medical Informatics Association, 2011
Background Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). Objective To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. Measurements A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. Results A total of 29 clinicians participated in the study. The attendance rate was 66% (N¼19) for the first and last month of focus-group meetings and 52% (N¼15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system.
The value of health information exchange
Journal of Healthcare Leadership, 2012
Health information exchange (HIE) is a key component of health care reform that enables clinical data sharing between providers, patients, and health care organizations. The value of HIE rests in the promise that more efficient and effective access to clinical data will improve patients' condition-specific outcomes relative to the costs. For example, improvements in outcomes may result from fewer medical errors and improved adherence to evidence-based recommendations, whereas reductions in costs may result from fewer duplicate tests and improved care coordination. However, even though health care reform efforts promote HIE as a way to improve care and curb costs, few studies demonstrate these results. We have organized the available evidence at national and regional levels to report on costs and benefits associated with HIE, and identify potential areas of future research.
Physicians' opinions of a health information exchange: Table 1
Journal of the American Medical Informatics Association, 2011
Background Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). Objective To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. Measurements A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. Results A total of 29 clinicians participated in the study. The attendance rate was 66% (N¼19) for the first and last month of focus-group meetings and 52% (N¼15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Conclusion Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.
Patient Education for Consumer-Mediated HIE
Applied Clinical Informatics, 2016
SummaryConsumer-mediated health information exchange (HIE) is one of the three types of HIE designated by the Office of the National Coordinator. HIE is intended to improve the quality of care while reducing cost, yet empirical support for this claim is mixed. Future research should identify the contexts whereby HIE is most effective.This study was conducted as a pilot two-arm randomized controlled trial. In the intervention arm, 27 veterans were taught how to generate a Continuity of Care Document (CCD) within the Blue Button feature of their VA patient portal and were then asked to share it with their community non-VA provider. In the attention control condition, 25 Veterans were taught how to look up health information on the Internet. The impact of this training on the next non-VA medical visit was examined.Nineteen (90%) veterans in the intervention arm shared their CCD with their non-VA provider as compared with 2 (17%) in the attention control arm (p<0.001). Both veterans ...