E-Health: Steps On The Road To Interoperability

James, Brent C.

doi:10.1377/hlthaff.w5.26

Cited by 18 publications

(9 citation statements)

References 3 publications

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“…As primary stakeholders, they are not only affected by national and local policy, medical services, and the health care workforce, but also have the ability to affect health care cost, quality, and access through individual and community engagement. Patient engagement is a broadly defined term used to describe patient acquisition of knowledge, skills, ability, and motivation to participate in positive health behaviors and the interventions increasing these attributes [1,2]. A wide range of factors including literacy level, personal interest, information quality and access, and knowledge impact a patient’s ability to engage in their health and health care [3-7].…”

Section: Introductionmentioning

confidence: 99%

Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

Chaet¹,

Morshedi²,

Wells³

et al. 2016

J Med Internet Res

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BackgroundAs consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions.ObjectiveOur aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics.MethodsA narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author’s last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics.ResultsWe included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child, infant, or maternal health were the most common health domains targeted by consumer health IT interventions. More than half of the interventions were culturally tailored. The most frequently used evaluation metric was behavior/attitude change, followed by usability and knowledge retention.ConclusionsThis study characterizes the existing body of research exploring consumer health IT interventions for the US Spanish-speaking Latino population. In doing so, it reveals three primary needs within the field. First, while the increase in studies targeting the Latino population in the last decade is a promising advancement, future research is needed that focuses on Latino subpopulations previously overlooked. Second, preliminary steps have been taken to culturally tailor consumer health IT interventions for the US Spanish-speaking Latino population; however, focus must expand beyond intervention content. Finally, the field should work to promote long-term evaluation of technology efficacy, moving beyond intermediary measures toward measures of health outcomes.

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Section: Introductionmentioning

confidence: 99%

Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

Chaet¹,

Morshedi²,

Wells³

et al. 2016

J Med Internet Res

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“…[2][3][4] However, even the lowest estimate of net benefit provides a strong business case for investment in Level 4 interoperability even without incorporating the quality improvement benefits described by DMR Consulting. 2,19,20 Thus, we believe this represents a lower bound of the benefit. Both Level 2 and Level 3 communication offer positive financial returns, although they are small in comparison with the value of Level 4 interoperability.…”

Section: Discussionmentioning

confidence: 89%

The economic benefits of health information exchange interoperability for Australia

Sprivulis¹,

Walker²,

Johnston³

et al. 2007

Aust. Health Review

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Objective: To estimate costs and benefits for Australia of implementing health information exchange interoperability among health care providers and other health care stakeholders. Design:A cost-benefit model considering four levels of interoperability (Level 1, paper based; Level 2, machine transportable; Level 3, machine readable; and Level 4, machine interpretable) was developed for Government-funded health services, then validated by expert review.Results: Roll-out costs for Level 3 and Level 4 interoperability were projected to be $21.5 billion and $14.2 billion, respectively, and steady-state costs, $1470 million and $933 million per annum, respectively. Level 3 interoperability would achieve steadystate savings of $1820 million, and Level 4 interoperability, $2990 million, comprising transactions of: laboratory $1180 million (39%); other providers, $893 million (30%); imaging centre, $680 million (23%); pharmacy, $213 million (7%) and public health, $27 million (1%). Net steady-state Level 4 benefits are projected to be $2050 million: $1710 million more than Level 3 benefits of $348 million, reflecting reduced interface costs for Level 4 interoperability due to standardisation of the semantic content of Level 4 messages. Conclusions:Benefits to both providers and society will accrue from the implementation of interoperability. Standards are needed for the semantic content of clinical messages, in addition to message exchange standards, for the full benefits of interoperability to be realised. An Australian Government policy position What are the implications for practitioners?The authors suggest that the greatest risk to achieving value from interoperability is not the cost of implementation, but whether or not rigorous standards for Level 4 interoperability are developed and implemented across Australia.

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“…The inconsistencies in documentation techniques make it difficult on developers of architecture for NHIN because it is difficult to recognize text to include in a universal, recognizable language used in the exchange of a patient's PHI. 42 …”

Section: Uncertain Costs Associated With Implementationmentioning

confidence: 99%

The Feasibility of the Nationwide Health Information Network

Valle

Gomes²,

Godby³

et al. 2016

The Health Care Manager

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The Nationwide Health Information Network (NHIN) use in health care facilities was examined for utilization and efficacy; although the advantages are abundant, health care facilities have been reluctant to adopt it because of associated costs. The purpose of this study was to analyze the feasibility of a US NHIN by exploring and determining the benefits of an NHIN and assessing the barriers to its implementation. The research methodology applied in examining the implementation of NHIN in the United States was a qualitative literature review, which followed the basic guidelines of a systematic literature review, partnered with a semistructured interview of a chief information officer of a private, nonprofit, 193-bed hospital located in Westminster, Maryland. A total of 33 sources were referenced. The results of this study suggest that implementation and utilization of NHIN by health care industry stakeholders lead to an increased quality of patient care, increased patient-provider communication, and cost-savings opportunities. Increased quality of care is achieved by reducing adverse drug events and medical errors. Cost-savings opportunities are generated by a reduction in spending and prices that is attributable to electronic health record systems' increased efficiency and effectiveness. Nevertheless, barriers to NHIN implementation and utilization still remain throughout the health care industry, the main one being concerns about interoperability.

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E-Health: Steps On The Road To Interoperability

Cited by 18 publications

References 3 publications

Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

The economic benefits of health information exchange interoperability for Australia

The Feasibility of the Nationwide Health Information Network

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