The complementary nature of query-based and directed health information exchange in primary care practice
dc.contributor.author | Vest, Joshua R. | |
dc.contributor.author | Unruh, Mark A. | |
dc.contributor.author | Casalino, Lawrence P. | |
dc.contributor.author | Shapiro, Jason S. | |
dc.contributor.department | Health Policy and Management, School of Public Health | en_US |
dc.date.accessioned | 2022-01-14T20:12:57Z | |
dc.date.available | 2022-01-14T20:12:57Z | |
dc.date.issued | 2020-01 | |
dc.description.abstract | Objective Many policymakers and advocates assume that directed and query-based health information exchange (HIE) work together to meet organizations’ interoperability needs, but this is not grounded in a substantial evidence base. This study sought to clarify the relationship between the usage of these 2 approaches to HIE. Materials and Methods System user log files from a regional HIE organization and electronic health record system were combined to model the usage of HIE associated with a patient visit at 3 federally qualified health centers in New York. Regression models tested the hypothesis that directed HIE usage was associated with query-based usage and adjusted for factors reflective of the FITT (Fit between Individuals, Task & Technology) framework. Follow-up interviews with 8 key informants helped interpret findings. Results Usage of query-based HIE occurred in 3.1% of encounters and directed HIE in 23.5%. Query-based usage was 0.6 percentage points higher when directed HIE provided imaging information, and 4.8 percentage points higher when directed HIE provided clinical documents. The probability of query-based HIE was lower for specialist visits, higher for postdischarge visits, and higher for encounters with nurse practitioners. Informants used query-based HIE after directed HIE to obtain additional information, support transitions of care, or in cases of abnormal results. Discussion The complementary nature of directed and query-based HIE indicates that both HIE functionalities should be incorporated into EHR Certification Criteria. Conclusions Quantitative and qualitative findings suggest that directed and query-based HIE exist in a complementary manner in ambulatory care settings. | en_US |
dc.eprint.version | Final published version | en_US |
dc.identifier.citation | Vest, J. R., Unruh, M. A., Casalino, L. P., & Shapiro, J. S. (2020). The complementary nature of query-based and directed health information exchange in primary care practice. Journal of the American Medical Informatics Association, 27(1), 73–80. https://doi.org/10.1093/jamia/ocz134 | en_US |
dc.identifier.issn | 1527-974X | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/27477 | |
dc.language.iso | en_US | en_US |
dc.publisher | Oxford Academic | en_US |
dc.relation.isversionof | 10.1093/jamia/ocz134 | en_US |
dc.relation.journal | Journal of the American Medical Informatics Association | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | primary health care | en_US |
dc.subject | community health centers | en_US |
dc.subject | health information exchange | en_US |
dc.subject | electronic health records | en_US |
dc.subject | medical informatics | en_US |
dc.title | The complementary nature of query-based and directed health information exchange in primary care practice | en_US |
dc.type | Article | en_US |
ul.alternative.fulltext | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647237/ | en_US |
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