Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and aligning budgets with the value of CE-PHEP to US national health security.
Objective. To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use. Data Sources. 2007-2010 National Hospital Ambulatory Medical Care Survey -ED Component. Study Design. We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use. Principal Findings. The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit. Conclusions. Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care. Key Words. Information technology in health, ambulatory care, hospital emergency departments Proponents of health information technology (IT) suggest that hospital emergency departments (EDs) are uniquely positioned to benefit from an electronic patient management system. Health IT in EDs could allow clinicians to have access to patient information from other providers, improve clinical decision support for complicated cases, and substitute electronic medication and test ordering for time-consuming, paper-based systems. These attributes may improve ED efficiency, reducing the time needed to spend with a
Our findings suggest that valuation of aspects of MC clinic design can diverge by decision maker. To better ensure utilization of services, these variations should be taken into account to prior to implementation of a national strategy in South Africa.
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