Accessing and sharing health information for post-discharge stroke care through a national health information exchange platform - a case study

Davoody, Nadia; Koch, Sabine; Krakau, Ingvar; Hägglund, Maria

doi:10.1186/s12911-019-0816-x

Cited by 19 publications

(17 citation statements)

References 39 publications

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“…Therefore, a national patient portal, “1177.se,” has been implemented ( 5 ). The portal runs on a national health information exchange (HIE) platform ( 22 , 23 ), and through this infrastructure, data stored in any of the EHR systems used in the 21 regions can be accessed. Authentication with an e-ID gives patients access to a number of administrative services as well as the PAEHR Journalen.…”

Section: Methodsmentioning

confidence: 99%

Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands

Cijvat

Cornet

Hägglund

2021

Front. Public Health

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Background: Patient-accessible electronic health records (PAEHRs) and associated national policies have increasingly been set up over the past two decades. Still little is known about the most effective strategy for developing and implementing PAEHRs. There are many stakeholders to take into account, and previous research focuses on the viewpoints of patients and healthcare professionals. Many known barriers and challenges could be solved by involving end-users in the development and implementation process. This study therefore compares barriers and facilitators for PAEHR development and implementation, both general and specific for patient involvement, that were present in Sweden and the Netherlands.Methods: There were a total of 14 semi-structured interviews with 16 key informants from both countries, on which content analysis was performed. The Consolidated Framework for Implementation Research was used to guide both the construction of the interview guides and the content analysis.Outcomes: The main barriers present in both countries are resistance from healthcare professionals and technical barriers regarding electronic health record systems and vendors. Facilitators varied across the two contexts, where the national infrastructure and program management were highlighted as facilitators in Sweden and stakeholder engagement (including patients and healthcare professionals) was described as a facilitator in both contexts. Strong leadership was also described as a critical success factor, especially when faced with healthcare professional resistance.Conclusion: Most of the major barriers and facilitators from both countries are covered in existing literature. This study, however, identified factors that can be seen as more practical and that would not have arisen from interviews with patients or physicians. Recommendations for policymakers include keeping the mentioned barriers in mind from the start of development and paving the way for facilitators, mainly strict policies, learning from peer implementers, and patient involvement, when possible. Implementers should focus on strong decision-making and project management and on preparing the healthcare organization for the PAEHR.

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Section: Methodsmentioning

confidence: 99%

Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands

Cijvat

Cornet

Hägglund

2021

Front. Public Health

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“…El intercambio de información entre profesionales incide en la calidad de la atención psicosocial prestada, facilitando la (a) adopción de prácticas de intervención basadas en la evidencia empírica, (b) la difusión de innovaciones y (c) la resolución de incidencias durante la atención 1,2,3,4 . Los problemas de comunicación afectan negativamente en la prestación de servicios, y la fluidez en el proceso de comunicación incide positivamente en la satisfacción de los pacientes y en la calidad de la atención 5 .…”

Section: Introductionunclassified

Factores individuales y grupales que inciden en el intercambio de información entre implementadores de programas de intervención: una visión estructural

et al. 2021

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Resumen: El intercambio de información entre los aplicadores de intervenciones en salud mental es esencial para garantizar la efectividad de la implementación de programas. El objetivo fue examinar cómo influyen factores individuales y grupales en el intercambio de información entre los implementadores de un programa de intervención psicosocial dirigido a víctimas de la guerra en Colombia. Se desarrolló un diseño exploratorio transversal. Fueron entrevistados 18 psicólogos, 22 trabajadores sociales, 10 promotores comunitarios y una enfermera. Se empleó el índice E-i y la visualización de vínculos interclase e intraclase. No existe tendencia homofílica en el intercambio de información entre las tres categorías profesionales. El empoderamiento predice las nominaciones recibidas en la red de solicitud de información (β = 0,296, p < 0,006). Ser central en la red de preferencia es el principal predictor de la recepción de peticiones de información (β = 0,562, p < 0,0001). Los profesionales empoderados y aquellos que intercambian información sobre el proceso de implementación son considerados informantes clave que pueden mejorar la efectividad del programa.

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“…27 Patient participation in health care decisions is regarded as an important factor affecting health care quality. 28 Thus, without the full support, participation, and endorsement of all stakeholders (such as health care professionals and patients), implementing a nationwide standard exchange mechanism would be challenging.…”

Section: Introduction Health Information Exchange (Hie) Mechanismsmentioning

confidence: 99%

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

Esmaeilzadeh

2020

Methods Inf Med

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Background Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs. Objectives Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector. Methods In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives. Results Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms. Conclusion This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

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Accessing and sharing health information for post-discharge stroke care through a national health information exchange platform - a case study

Cited by 19 publications

References 39 publications

Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands

Factors Influencing Development and Implementation of Patients' Access to Electronic Health Records—A Comparative Study of Sweden and the Netherlands

Factores individuales y grupales que inciden en el intercambio de información entre implementadores de programas de intervención: una visión estructural

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

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