Health information exchange: persistent challenges and new strategies: Table 1

Vest, Joshua R.; Gamm, Larry

doi:10.1136/jamia.2010.003673

Cited by 319 publications

(204 citation statements)

References 26 publications

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“…While the data are even sparser, trade reports and some research indicated that the enterprise HIE approach has also grown rapidly (Harris Healthcare Solutions, 2012). This difference in trajectories within the population of HIOs (described in detail by Lenert et al, 2012;Rubin, 2003;Vest & Gamm, 2010) suggests the possibility of selection forces at work.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…Population ecology allows for individual organizations to evolve, adapt, and even cooperate in response to environmental pressures overtime (Singh & Lumsden, 1990). HIOs have changed over time to meet the expectations of the environment (Vest & Gamm, 2010) and have created partnerships in attempts to position themselves within the market for information exchange service (see, for the most recent example, the cooperation between Carequality and CommonWell). Additionally, some changes to HIOs are isomorphic, suggesting the action of institutional pressures in the environment.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

See 1 more Smart Citation

A population ecology perspective on the functioning and future of health information organizations

Vest

Menachemi²

2017

Health Care Manage Rev

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Section: Theoretical Frameworkmentioning

confidence: 99%

Section: Theoretical Frameworkmentioning

confidence: 99%

A population ecology perspective on the functioning and future of health information organizations

Vest

Menachemi²

2017

Health Care Manage Rev

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“…Our study addresses this gap by exploring the association between the key factors and HIE usage by ambulatory care providers. Our research objectives are twofold: (1) [19,21].…”

Section: Introductionmentioning

confidence: 99%

“…Even among those shared data, providers can restrict the type and amount of healthcare information that is shared [21].…”

Section: Introductionmentioning

confidence: 99%

Key Factors Affecting Ambulatory Care Providers’ Electronic Exchange of Health Information With Affiliated and Unaffiliated Partners: Web-Based Survey Study (Preprint)

Pendergrass¹,

Ranganathan²

2018

Preprint

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BACKGROUND Despite the potential benefits of electronic health information exchange (HIE) to improve the quality and efficiency of care, HIE use by ambulatory providers remains low. Ambulatory providers can greatly improve the quality of care by electronically exchanging health information with affiliated providers within their health care network as well as with unaffiliated, external providers. OBJECTIVE This study aimed to examine the extent of electronic HIE use by ambulatory clinics with affiliated providers within their health system and with external providers, as well as the key technological, organizational, and environmental factors affecting the extent of HIE use within and outside the health system. METHODS A Web-based survey of 320 ambulatory care providers was conducted in the state of Illinois. The study examined the extent of HIE usage by ambulatory providers with hospitals, clinics, and other facilities within and outside their health care system–encompassing seven kinds of health care data. Ten factors pertaining to technology (IT [information technology] Compatibility, External IT Support, Security & Privacy Safeguards), organization (Workflow Adaptability, Senior Leadership Support, Clinicians Health-IT Knowledge, Staff Health-IT Knowledge), and environment (Government Efforts & Incentives, Partner Readiness, Competitors and Peers) were assessed. A series of multivariate regressions were used to examine predictor effects. RESULTS The 6 regressions produced adjusted R-squared values ranging from 0.44 to 0.63. We found that ambulatory clinics exchanged more health information electronically with affiliated entities within their health system as compared with those outside their health system. Partner readiness emerged as the most significant predictor of HIE usage with all entities. Governmental initiatives for HIE, clinicians’ prior familiarity and knowledge of health IT systems, implementation of appropriate security, and privacy safeguards were also significant predictors. External information technology support and workflow adaptability emerged as key predictors for HIE use outside a clinic’s health system. Differences based on clinic size, ownership, and specialty were also observed. CONCLUSIONS This study provides exploratory insights into HIE use by ambulatory providers within and outside their health care system and differential predictors that impact HIE use. HIE use can be further improved by encouraging large-scale interoperability efforts, improving external IT support, and redesigning adaptable workflows.

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“…Health information exchanges (HIEs) require a synthesis of goals, protocols, data formats, and infrastructure within and across organizations. The partners in a HIE are likely to think of, and govern themselves as, stand-alone entities and may have very different institutional cultures and practices [3][4][5]. When the data to be exchanged happen to be HIV-related, the potential barriers are further complicated by legal and organizational precedents that place primacy on the protection and limited distribution of health information in light of historical-and, to a lesser degree, continuing-stigmatization of the disease [6].…”

Section: Introductionmentioning

confidence: 99%

The essential role of reconfiguration capabilities in the implementation of HIV-related health information exchanges

Steward

Koester

Collins

et al. 2012

International Journal of Medical Informatics

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Methods:We conducted 111 semi-structured interviews with project staff and information technology (IT) specialists associated with the demonstration projects, staff from community-based organizations and public health agencies collaborating in the design and implementation of the HIEs, and providers who used each HIE. The dynamic capability framework guided analyses. In the context of a HIE, the framework's components include information systems (the actual technological exchange systems and capacity to update them), absorptive capacity (the ability to implement an operating HIE), reconfiguration capacity (the ability to adapt workflows and clinical practices in response to a HIE), and organizational size and human resources (characteristics likely to affect a clinic's ability to respond).Results: Across the projects, we found evidence for the importance of three dynamic capabilities: information systems, reconfiguration capacity, and organizational size and human resources. However, of these three, reconfiguration capacity was the most salient. Implementation outcomes at all six of the projects were shaped substantially by the degree of attention dedicated to reworking procedures and practices so that HIE usage became routine. Conclusion:Electronic information exchange offers the promise of improved coordination of care. However, implementation of HIEs goes beyond programing and hardware installation challenges, and requires close attention to the needs of the HIEs end-users. Providers need to discern value from a HIE because their active participation is essential to ensuring that clinic and agency practices and procedures are reconfigured to incorporate new systems into daily work processes. i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 1 ( 2 0 1 2 ) e10-e20 e11 1.

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Health information exchange: persistent challenges and new strategies: Table 1

Cited by 319 publications

References 26 publications

A population ecology perspective on the functioning and future of health information organizations

A population ecology perspective on the functioning and future of health information organizations

Key Factors Affecting Ambulatory Care Providers’ Electronic Exchange of Health Information With Affiliated and Unaffiliated Partners: Web-Based Survey Study (Preprint)

The essential role of reconfiguration capabilities in the implementation of HIV-related health information exchanges

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