Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making
Introduction: The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been perfor...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2015-12-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/0m96v1ss |
| Summary: | Introduction: The objective of the study was to understand the immediate utility of health
information exchange (HIE) on emergency department (ED) providers by interviewing them shortly
after the information was retrieved. Prior studies of physician perceptions regarding HIE have only
been performed outside of the care environment.
Methods: Trained research assistants interviewed resident physicians, physician assistants and
attending physicians using a semi-structured questionnaire within two hours of making a HIE
request. The responses were recorded, then transcribed for qualitative analysis. The transcribed
interviews were analyzed for emerging qualitative themes.
Results: We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes
discovered included the following: drivers for requests for outside information; the importance
of unexpected information; historical lab values as reference points; providing context when
determining whether to admit or discharge a patient; the importance of information in refining
disposition; improved confidence of provider; and changes in decisions for diagnostic imaging.
Conclusion: ED providers are driven to use HIE when they’re missing a known piece of information.
This study finds two additional impacts not previously reported. First, providers sometimes find
additional unanticipated useful information, supporting a workflow that lowers the threshold to
request external information. Second, providers sometimes report utility when no changes to their
existing plan are made as their confidence is increased based on external records. Our findings are
concordant with previous studies in finding exchanged information is useful to provide context for
interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging. |
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| ISSN: | 1936-900X 1936-9018 |