Organizational characteristics and perceptions of clinical event notification services in healthcare settings: a study of health information exchange

Abstract

Objective Event notification systems are an approach to health information exchange (HIE) that notifies end-users of patient interactions with the healthcare system through real-time automated alerts. We examined associations between organizational capabilities and perceptions of event notification system use. Materials and Methods We surveyed representatives (n = 196) from healthcare organizations (n = 96) that subscribed to 1 of 3 Health Information Organizations’ event notification services in New York City (response rate = 27%). The survey was conducted in Fall 2017 and Winter 2018. Surveys measured respondent characteristics, perceived organizational capabilities, event notification use, care coordination, and care quality. Exploratory factor analysis was used to identify relevant independent and dependent variables. We examined the relationship between organizational capabilities, care coordination, and care quality using multilevel linear regression models with random effects. Results Respondents indicated that the majority of their organizations provided follow-up care for emergency department visits (66%) and hospital admissions (73%). Perceptions of care coordination were an estimated 57.5% (β = 0.575; P < 0.001) higher among respondents who reported event notifications fit within their organization’s existing workflows. Perceptions of care quality were 46.5% (β = 0.465; P < 0.001) higher among respondents who indicated event notifications fit within existing workflows and 23.8% (β = 0.238; P < 0.01) higher where respondents reported having supportive policies and procedures for timely response and coordination of event notifications. Discussion and Conclusion Healthcare organizations with specific workflow processes and positive perceptions of fit are more likely to use event notification services to improve care coordination and care quality. In addition, event notification capacity and patient consent procedures influence how end-users perceive event notification services.

Perceptions of information continuity key to understanding quality of post-acute care transitions

“…SNF leadership could also implement organizational infrastructure supports—policies, procedures, and workflows—that reinforce those routines (Goh et al, 2011; Jasperson et al, 2005). Recent work on health information exchange demonstrates that health care organizations with these supports for information sharing practices perceive more coordinated and higher-quality communication, even when the actual information sharing mechanism—the design, content, and timing of it—is the same for all participating organizations (Wiley et al, 2020). This reinforces the idea that whereas information sharing practices are defined between a sender and a receiver, perceptions of that process by either organization are filtered through the organizational context—the transitional care environment—in which they must process that information to deliver care.…”

“…This includes, for example, systematizing intake processes or use of decision support tools that more easily identify gaps or errors in a workflow. The absence of these supports can amplify the difficulty staff perceive in their work (Goh et al, 2011; Wiley et al, 2020).…”

Use of the Direct Standard for Patient Event Notifications: A Qualitative Study Among Industry Leaders

“…• Receivers having workflows, resources, and processes in place to handle the event notifications sent (VA and non-VA receivers; multiple transport methods). 18,22,37 • Decreasing the negative impact on the receiver's workflow (non-VA; unspecified transport method). 38 • Senders including higher quality data in the event notification sent (non-VA; unknown transport method).…”