Browsing by Subject "Meaningful use"
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Item Corrigendum to: Practice and market factors associated with provider volume of health information exchange(Oxford University Press, 2021) Apathy, Nate C.; Vest, Joshua R.; Adler-Milstein, Julia; Blackburn, Justin; Dixon, Brian E.; Harle, Christopher A.; Health Policy and Management, Richard M. Fairbanks School of Public HealthJournal of the American Medical Informatics Association, doi: 10.1093/jamia/ocab024 The author name “Julia Adler-Milstein” was incorrectly given as “Julia Adler-Milstien”. This has been corrected online.Item Impact of document consolidation on healthcare providers’ perceived workload and information reconciliation tasks: a mixed methods study(Oxford University Press, 2019-02) Hosseini, Masoud; Faiola, Anthony; Jones, Josette; Vreeman, Daniel J.; Wu, Huanmei; Dixon, Brian E.; Medicine, School of MedicineBackground Information reconciliation is a common yet complex and often time-consuming task performed by healthcare providers. While electronic health record systems can receive “outside information” about a patient in electronic documents, rarely does the computer automate reconciling information about a patient across all documents. Materials and Methods Using a mixed methods design, we evaluated an information system designed to reconcile information across multiple electronic documents containing health records for a patient received from a health information exchange (HIE) network. Nine healthcare providers participated in scenario-based sessions in which they manually consolidated information across multiple documents. Accuracy of consolidation was measured along with the time spent completing 3 different reconciliation scenarios with and without support from the information system. Participants also attended an interview about their experience. Perceived workload was evaluated quantitatively using the NASA-TLX tool. Qualitative analysis focused on providers’ impression of the system and the challenges faced when reconciling information in practice. Results While 5 providers made mistakes when trying to manually reconcile information across multiple documents, no participants made a mistake when the system supported their work. Overall perceived workload decreased significantly for scenarios supported by the system (37.2% in referrals, 18.4% in medications, and 31.5% in problems scenarios, P < 0.001). Information reconciliation time was reduced significantly when the system supported provider tasks (58.8% in referrals, 38.1% in medications, and 65.1% in problem scenarios). Conclusion Automating retrieval and reconciliation of information across multiple electronic documents shows promise for reducing healthcare providers’ task complexity and workload.Item Practice and market factors associated with provider volume of health information exchange(Oxford University Press, 2021) Apathy, Nate C.; Vest, Joshua R.; Adler-Milstein, Julia; Blackburn, Justin; Dixon, Brian E.; Harle, Christopher A.; Health Policy and Management, School of Public HealthObjective: To assess the practice- and market-level factors associated with the amount of provider health information exchange (HIE) use. Materials and methods: Provider and practice-level data was drawn from the Meaningful Use Stage 2 Public Use Files from the Centers for Medicare and Medicaid Services, the Physician Compare National Downloadable File, and the Compendium of US Health Systems, among other sources. We analyzed the relationship between provider HIE use and practice and market factors using multivariable linear regression and compared primary care providers (PCPs) to non-PCPs. Provider volume of HIE use is measured as the percentage of referrals sent with electronic summaries of care (eSCR) reported by eligible providers attesting to the Meaningful Use electronic health record (EHR) incentive program in 2016. Results: Providers used HIE in 49% of referrals; PCPs used HIE in fewer referrals (43%) than non-PCPs (57%). Provider use of products from EHR vendors was negatively related to HIE use, while use of Athenahealth and Greenway Health products were positively related to HIE use. Providers treating, on average, older patients and greater proportions of patients with diabetes used HIE for more referrals. Health system membership, market concentration, and state HIE consent policy were unrelated to provider HIE use. Discussion: HIE use during referrals is low among office-based providers with the capability for exchange, especially PCPs. Practice-level factors were more commonly associated with greater levels of HIE use than market-level factors. Conclusion: This furthers the understanding that market forces, like competition, may be related to HIE adoption decisions but are less important for use once adoption has occurred.Item The Long Road to Semantic Interoperability in Support of Public Health: Experiences from Two States(Elsevier, 2014) Dixon, Brian E.; Vreeman, Daniel J.; Grannis, Shaun J.; Medicine, School of MedicineProliferation of health information technologies creates opportunities to improve clinical and public health, including high quality, safer care and lower costs. To maximize such potential benefits, health information technologies must readily and reliably exchange information with other systems. However, evidence from public health surveillance programs in two states suggests that operational clinical information systems often fail to use available standards, a barrier to semantic interoperability. Furthermore, analysis of existing policies incentivizing semantic interoperability suggests they have limited impact and are fragmented. In this essay, we discuss three approaches for increasing semantic interoperability to support national goals for using health information technologies. A clear, comprehensive strategy requiring collaborative efforts by clinical and public health stakeholders is suggested as a guide for the long road towards better population health data and outcomes.