Browsing by Subject "Health Information Exchange (HIE)"

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    Changes in Health Information Exchange Use Behavior After Introduction of a Fast Healthcare Interoperability Resources (FHIR) Application
    (American Medical Informatics Association, 2025-05-22) Kampman, Haleigh M.; Rivera, Rebecca L.; Park, Seho; Schaffer, Jason T.; Hancock, Amy; Rahurkar, Saurabh; Musey, Paul; Kuhn, Diane; Vest, Joshua R.; Schleyer, Titus K.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    The aim of our study was to characterize emergency department clinicians' health information exchange (HIE) use patterns after the implementation of a Fast Healthcare Interoperability Resources (FHIR) application. Using longitudinal electronic health record log data, we categorized HIE use behavior as: no HIE use (0), Web-based viewer use only (1), FHIR application use only (2), or Web-based viewer and FHIR application use (3). We sequenced HIE use behavior from September 2019 to February 2023, then employed hierarchical agglomerative clustering to identify clinician characteristics associated with each HIE use pattern. Our results showed four usage patterns representing (1) clinicians who "lagged" in HIE use and continued as sporadic HIE users (n=66, 46.1%), (2) "late adopters" who had more consistent usage over time (n=32, 22.4%), (3) "legacy users" whose preferred modality was the Web-based viewer (n=25, 17.5%), and (4) "mixed modality users" who displayed frequent changes in HIE access modality (n=20, 14.0%).
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    Consolidation of CDA-based documents from multiple sources : a modular approach
    (2016-09) Hosseini Asanjan, Seyed Masoud; Jones, Josette F.; Dixon, Brian E.; Vreeman, Daniel J.; Faiola, Anthony; Wu, Huanmei
    Physicians receive multiple CCDs for a single patient encompassing various encounters and medical history recorded in different information systems. It is cumbersome for providers to explore different pages of CCDs to find specific data which can be duplicated or even conflicted. This study describes the steps towards a system that integrates multiple CCDs into one consolidated document for viewing or processing patient-level data. Also, the impact of the system on healthcare providers’ perceived workload is evaluated. A modular system is developed to consolidate and de-duplicate CDA-based documents. The system is engineered to be scalable, extensible and open source. The system’s performance and output has evaluated first based on synthesized data and later based on real-world CCDs obtained from INPC database. The accuracy of the consolidation system along with the gaps in identification of the duplications were assessed. Finally, the impact of the system on healthcare providers’ workload is evaluated using NASA TLX tool. All of the synthesized CCDs were successfully consolidated, and no data were lost. The de-duplication accuracy was 100% based on synthesized data and the processing time for each document was 1.12 seconds. For real-world CCDs, our system de-duplicated 99.1% of the problems, 87.0% of allergies, and 91.7% of medications. Although the accuracy of the system is still very promising, however, there is a minor inaccuracy. Due to system improvements, the processing time for each document is reduced to average 0.38 seconds for each CCD. The result of NASA TLX evaluation shows that the system significantly decreases healthcare providers’ perceived workload. Also, it is observed that information reconciliation reduces the medical errors. The time for review of medical documents review time is significantly reduced after CCD consolidation. Given increasing adoption and use of Health Information Exchange (HIE) to share data and information across the care continuum, duplication of information is inevitable. A novel system designed to support automated consolidation and de-duplication of information across clinical documents as they are exchanged shows promise. Future work is needed to expand the capabilities of the system and further test it using heterogeneous vocabularies across multiple HIE scenarios.