Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

Abstract

Objective: We examined physicians' perceived needs, benefits, and concerns regarding health information exchange (HIE) technology prior to experiencing it and their actual usage of exchanged information in care processes during an HIE pilot program in South Korea. Materials and Methods: We conducted a survey through a structured questionnaire to collect data on physician perceptions about an HIE prior to implementation. We analyzed responses using descriptive statistics and one-way analyses of variance. We also conducted a post-implementation survey through a computerized tool designed to collect data on physician assessment of HIE item usefulness. We defined two indices to measure the volume of information flow and usefulness for individual HIE items and analyzed the indices with Fisher's exact test. Results: Physicians' overall perceptions about the need for an HIE and benefits of the technology were positive despite their concerns about information safety and security, system costs, and disputes between care providers in cases of malpractice. We found that physician practice settings significantly influenced the details of their perceptions. In the both pre-and post-implementation studies, the most needed and valued information were pathology and lab results, diagnostic imaging, medication, and working diagnosis. Physicians most agreed with the benefit potentials in the quality domain, least agreed with those in time and cost savings of healthcare delivery, and least worried about the decrease in revenues resulting from the technology. Conclusions: The overall physician acceptance of the HIE technology in South Korea is promising, but the adoption and diffusion strategy needs to be tailored to the type of physician practice. Concerted efforts may be needed to realize the much-anticipated potential of healthcare cost savings.

Health information exchange in Finland: Usage of different access types and predictors of paper use

“…In the 2010 analysis [9] type 1 predicted lower likelihood of experiencing RHIS support for cross-organizational collaboration and higher likelihood of usability problems, which may explain the higher use of paper in these regions still in 2017 (Types 4 and 5 were not assessed in the earlier analysis). According to previous studies, usability [11][12][13][14] and practice setting [15,16] predict usage, and specialty, satisfaction with push HIE, improved access to complete info [15,18,26] predict overall satisfaction with HIE.…”

“…• Usage rate of HIE after implementation is often low, even if clear benefits can be shown [10] • Usability [11][12][13][14] and practice setting [15][16][17] predict usage of the…”

Crucial Factors for the Acceptance of a Computerized National Medication List

“…The results of the current study correlate with a number of similar studies regarding trans-institutional information systems and/or IT-based information exchange. It is notable that many more surveys of physicians [17][18][19][20] than surveys of pharmacists [21] on this topic exist. Their results, e.g.…”

“…Their results, e.g. from the US [19] or Korea [20], show that in other countries physicians are concerned with information security and privacy as well when health information exchange is established. Similar concerns could be found in a study where the acceptance of an EHR among physicians in Austria was investigated [22].…”

Defining Health Information Exchange: Scoping Review of Published Definitions

“…‘Technology platform’,43 , 47 , 165 , 225 , 260 ‘network infrastructure’,42 , 102 , 109 , 126 , 131 , 219 , 227 , 249 , 260 – 269 ‘health information technology’,154 , 172 , 189 ‘computer-based systems’,226 ‘technology model’,126 ‘information technology’,52 , 65 , 81 , 147 , 248 , 259 , 270 ‘HIE systems’,271 , 272 ‘document exchange system’,26 , 27 , 253 use of ‘online metadata registry’,242 ‘powerful technology’,273 ‘Web-based delivery systems’,215 ‘technical infrastructure’,133 , 267 ‘information infrastructure’,274 ‘electronic networks’,106 ‘electronic system’,152 ‘portal’,41 ‘computer network’,187 ‘interoperable technologies’,275 ‘central information systems’,159 ‘collection of activities and technologies’,104 , 276 ‘component of innovative’, 277 ‘friendly user interfaces’,278 ‘secured website’,116 , 170 ‘communication based on Web services’,51 ‘health care technology’,96 ‘health information systems’,265 ‘mobile computing technology’,119 ‘hubs’,136 ‘open source’231 and ‘data formats.’249…”