Health information exchange in small-to-medium sized family medicine practices: Motivators, barriers, and potential facilitators of adoption

Se, Ross; Schilling, Lisa M.; Fernald, Douglas H.; Davidson, Arthur J.; West, D. R. F.

doi:10.1016/j.ijmedinf.2009.12.001

Cited by 77 publications

(77 citation statements)

References 9 publications

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“…3 Beyond the technical challenges to information sharing, other factors such as internal workflows and lack of reimbursement for care coordination can limit successful use of health IT for care coordination. 2,5,6 Implementing some aspects of care coordination is an expectation for clinicians who participate in the Centers for Medicare and Medicaid Services EHR incentive program for "meaningful use" of health IT (commonly known as the Meaningful Use or MU program). Although thousands of primary care clinicians have participated in this incentive program, adoption of the optional care coordination objectives is limited.…”

Section: Introductionmentioning

confidence: 99%

Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

Morton

Shih

Winther

et al. 2015

The Annals of Family Medicine

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PURPOSE Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. METHODSWe surveyed physician-owned and hospital/health system-affiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities.RESULTS Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practice's capacity for systematic change.CONCLUSIONS Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians' priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination. Ann Fam Med 2015;13:250-256. doi: 10.1370/afm.1797. INTRODUCTIONC oordinating patient care is important for several reasons including the delivery of consistent guidance and recommendations, avoidance of unnecessary and/or duplicative testing, and ensuring timely access to services. A recent national survey showed that onethird of patients reported experiencing a gap in exchange of information between health care professionals involved in their care or between themselves and their health care professionals. Electronic health records (EHRs) and other health information technology (IT) offer the promise of making information sharing easier. 2Existing research shows infrequent use of health IT for care coordination, however. 3,4 Even in settings where use of health IT is widespread, connectivity with other practices or facilities can be difficult.3 Beyond the technical challenges to information sharing, other factors such as internal workflows and lack of reimbursement for care coordination can limit successful use of health IT for care coordination. 2,5,6 Suzanne Morton, MPH METHODS Over...

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Section: Introductionmentioning

confidence: 99%

Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

Morton

Shih

Winther

et al. 2015

The Annals of Family Medicine

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“…Some suppose that a lack of financial incentives is a large barrier to adoption, 18 whereas others counter that improvements in the quality of care may outweigh economic concerns. 19 In the USA, direct financial incentives for HIE can come from governmentfunded initiatives such as Meaningful Use 20 and qualification for a patient-centred medical home. 18 However, it remains to be seen if notification systems will have an effect on hospital or population-based savings.…”

Section: Discussionmentioning

confidence: 99%

Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey

Altman¹,

Shapiro²,

Moore³

et al. 2013

Journal of Innovation in Health Informatics

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“…People issues, ranging from user acceptance [39], [40], perceived ease of use [41], lack of knowledge about the system [35], [42], [43], lack of training, lack of stakeholder consultation [44], lack of willingness to assimilate the technology in to daily routines and processes [45], [46] , conflict between system and user embedded values [45], [46], complex and complicated user interfaces [31], conflict between physician activities and training schedules [42], [47], [48] and complications in patient-provider communications are some of the major concerns. It is paramount that the systems are user centric and have a good fit with user values as well as existing healthcare systems.…”

Section: Literature Reviewmentioning

confidence: 99%

Critical Issues in Implementing and Adopting National e-Health Solutions: Lessons from Australia’s MyHealth Record

Muhammad

Wickramasinghe

2018

Proceedings of the 51st Hawaii International Conference on System Sciences

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Globally, healthcare reforms are being initiated to address the tremendous challenges facing healthcare systems. Without exception, these reforms include the implementation of a variety of e-health solutions. Such e-health solutions are complex and have far reaching implications. We argue that while these implementations and adoptions of e-health solutions are necessary, it is essential that an appropriate lens of analysis should be used to maximise and sustain the benefits of IS/IT (information systems/information technology) in healthcare delivery. Hence, in this paper, we proffer Actor-Network Theory (ANT) as an appropriate lens to evaluate these various e-health solutions and illustrate in the context of MyHealth Record, the chosen e-health solution for Australia. The results of this study reveal that the implementation of eHealth is a complex process and approaching it nationally, serves to make it significantly more challenging with enormous barriers.

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Health information exchange in small-to-medium sized family medicine practices: Motivators, barriers, and potential facilitators of adoption

Cited by 77 publications

References 9 publications

Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey

Critical Issues in Implementing and Adopting National e-Health Solutions: Lessons from Australia’s MyHealth Record

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