The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review

Sadoughi, Farahnaz; Nasiri, Somayeh; Ahmadi, Hossein

doi:10.1016/j.cmpb.2018.04.023

Cited by 54 publications

(36 citation statements)

References 60 publications

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“…Complete and timely information exchange is an important precondition for collaboration and coordination of healthcare for patients with lung cancer. 8 The perspective of health professionals was examined in a previous study, 9 but the perspective of patients and informal caregivers is still unknown. Due to the severity of the disease, informal caregivers often play an important role in the planning of treatment and care for the patient.…”

Section: Open Accessmentioning

confidence: 99%

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

Bossert

Forstner

Villalobos³

et al. 2020

BMJ Open

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BackgroundPatients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors.MethodsThis qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.ResultsIn 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration.ConclusionPatients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients’ willingness of taking on a more active role in healthcare coordination.Trial registration numberDRKS00013469.

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Section: Open Accessmentioning

confidence: 99%

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

Bossert

Forstner

Villalobos³

et al. 2020

BMJ Open

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“…relaxing the constraint of services for older people). Five reviews 79,[106][107][108][109] were included.…”

Section: Broader Search Resultsmentioning

confidence: 99%

“…The authors concluded that 'the findings from this evidence-based analysis raise doubts about the ability of e-tools with care co-ordination capabilities to independently improve the quality of outpatient care'. 106 Sadoughi et al 107 conducted a systematic review on the impact of HIE on quality of care, cost-effectiveness and use. The authors found 32 studies that satisfied their inclusion criteria.…”

Section: Broader Search Resultsmentioning

confidence: 99%

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The effects of interoperable information technology networks on patient safety: a realist synthesis

Keen

Abdulwahid

King

et al. 2020

Health Serv Deliv Res

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Background Interoperable networks connect information technology systems of different organisations, allowing professionals in one organisation to access patient data held in another one. Health policy-makers in many countries believe that they will improve the co-ordination of services and, hence, the quality of services and patient safety. To the best of our knowledge, there have not been any previous systematic reviews of the effects of these networks on patient safety. Objectives The aim of the study was to establish how, why and in what circumstances interoperable information technology networks improved patient safety, failed to do so or increased safety risks. The objectives of the study were to (1) identify programme theories and prioritise theories to review; (2) search systematically for evidence to test the theories; (3) undertake quality appraisal, and use included texts to support, refine or reject programme theories; (4) synthesise the findings; and (5) disseminate the findings to a range of audiences. Design Realist synthesis, including consultation with stakeholders in nominal groups and semistructured interviews. Settings and participants Following a stakeholder prioritisation process, several domains were reviewed: older people living at home requiring co-ordinated care, at-risk children living at home and medicines reconciliation services for any patients living at home. The effects of networks on services in health economies were also investigated. Intervention An interoperable network that linked at least two organisations, including a maximum of one hospital, in a city or region. Outcomes Increase, reduction or no change in patients’ risks, such as a change in the risk of taking an inappropriate medication. Results We did not find any detailed accounts of the ways in which interoperable networks are intended to work and improve patient safety. Theory fragments were identified and used to develop programme and mid-range theories. There is good evidence that there are problems with the co-ordination of services in each of the domains studied. The implicit hypothesis about interoperable networks is that they help to solve co-ordination problems, but evidence across the domains showed that professionals found interoperable networks difficult to use. There is insufficient evidence about the effectiveness of interoperable networks to allow us to establish how and why they affect patient safety. Limitations The lack of evidence about patient-specific measures of effectiveness meant that we were not able to determine ‘what works’, nor any variations in what works, when interoperable networks are deployed and used by health and social care professionals. Conclusions There is a dearth of evidence about the effects of interoperable networks on patient safety. It is not clear if the networks are associated with safer treatment and care, have no effects or increase clinical risks. Future work Possible future research includes primary studies of the effectiveness of interoperable networks, of economies of scope and scale and, more generally, on the value of information infrastructures. Study registration This study is registered as PROSPERO CRD42017073004. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 40. See the NIHR Journals Library website for further project information.

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“…In a recent systematic review of 25 studies that evaluated the effect of HIE on quality and/or costs, slightly over half (60%) found HIE cost-effective. 6 Conversely, some studies found higher costs associated with HIE adoption. 7,8 Any patient may at times choose to seek care beyond his or her usual provider or health care system, thus increasing the risk of duplication of services.…”

Section: Introductionmentioning

confidence: 99%

Impact of Patient Portal Use on Duplicate Laboratory Tests in Diabetes Management

Wakefield

Turvey

Hogan

et al. 2020

Telemedicine and e-Health

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Background: Patients seek care across multiple health care settings. One coordination issue is the unnecessary duplication of laboratory across different health care settings. This analysis examined the association between patient portal use and duplication of laboratory testing among Veterans who are dual users of Veterans Affairs (VA) and non-VA providers. Materials and Methods: A national sample of Veterans who were newly authenticated users of the portal during fiscal year (FY) 2013 who used Blue Button at least once were compared with a random sample of Veterans who were not registered to use the portal. From these two groups, Veterans who were also Medicare-eligible users in FY2014 were identified. Duplicate testing was defined as receipt of more than five HbA1c (hemoglobin A1c) in 1 year. Results: Use of the Blue Button decreased the odds of duplicate HbA1c testing in VA and Medicare-covered facilities across three comparisons: (1) overall between users and nonusers: portal users were less likely to have duplicate testing; (2) prepost comparison: there was a trend toward lower duplicate testing in both groups across time; and (3) pre-post comparisons accounting for use of the portal: the trend toward lower duplicate testing was greater in Blue Button users. Conclusion: Duplicate HbA1c testing was significantly lower in dual users of VA and Medicare services who used the Blue Button feature of their VA patient portal. Non-VA providers encounter barriers to access of complete information about Veterans who also use VA health care. Provider endorsement of consumer-mediated health information exchange could help further this model of sharing information.

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The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review

Cited by 54 publications

References 60 publications

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study

The effects of interoperable information technology networks on patient safety: a realist synthesis

Impact of Patient Portal Use on Duplicate Laboratory Tests in Diabetes Management

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