scholarly journals Implications for informatics given expanding access to care for Veterans and other populations

2015 ◽  
Vol 22 (4) ◽  
pp. 917-920 ◽  
Author(s):  
Brian E Dixon ◽  
David A Haggstrom ◽  
Michael Weiner
Keyword(s):  
Access To Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Department Of Veterans Affairs ◽  
Expanded Access ◽  
The Us ◽  
Timely Access ◽  
New Policies ◽  
New Research

Abstract Recent investigations into appointment scheduling within facilities operated by the US Department of Veterans Affairs (VA) illuminate systemic challenges in meeting its goal of providing timely access to care for all Veterans. In the wake of these investigations, new policies have been enacted to expand access to care at VA facilities as well as non-VA facilities if the VA is unable to provide access within a reasonable timeframe or a Veteran lives more than 40 miles from a VA medical facility. These policies are similar to broader health reform efforts that seek to expand access to care for other vulnerable populations. In this perspective, we discuss the informatics implications of expanded access within the VA and its wider applicability across the US health system. Health systems will require robust health information exchange, to maintain coordination while access to care is expanded. Existing informatics research can guide short-term implementation; furthermore, new research is needed to generate evidence about how best to achieve the long-term aim of expanded access to care.

scholarly journals Access to Care for Homeless Veterans During Disasters

2018 ◽  
Vol 9 ◽  
pp. 215013271881538
Author(s):  
Alicia R. Gable ◽  
Claudia Der-Martirosian ◽  
Aram Dobalian
Keyword(s):  
Access To Care ◽  
Natural Disaster ◽  
Department Of Veterans Affairs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medicaid Coverage ◽  
Homeless Veterans ◽  
Medical Centers ◽  
Medical Facilities ◽  
The Us

Introduction: Since 1970, natural disasters have led to both temporary and permanent closures of multiple medical centers and outpatient clinics at the US Department of Veterans Affairs (VA) nationwide. Access to care during such events is critical for vulnerable populations, especially homeless veterans. As such, facility closures may disproportionately affect homeless veteran patients who are both more likely to experience adverse effects from disasters and face multiple barriers to care. Methods: A cross-sectional survey was administered to a probability sample of 2000 homeless VA patients living in and receiving VA health care in the Northeast United States. The survey was completed by 383 respondents (20% adjusted response rate). This pilot study examines predictors of difficulty accessing care in the event that the VA facility that homeless VA patients routinely use is forced to close because of a natural disaster. Results: In a multivariate logistic regression, homeless VA patients who had Medicaid were less likely (OR 0.38; 95% CI: 0.18-0.78; P < .01) to report that they would have difficulty obtaining care elsewhere if their normal VA facility was closed in a future natural disaster. Conclusions: Findings suggest that Medicaid coverage has the potential to facilitate access to care for homeless veteran VA patients during disasters. Policy changes that decrease Medicaid coverage could limit access to care for homeless veterans during closures of VA medical facilities.

scholarly journals What Affects Clinicians’ Usage of Health Information Exchange?

2011 ◽  
Vol 02 (03) ◽  
pp. 250-262 ◽  
Author(s):  
L. Volk ◽  
S. Simon ◽  
D. Bates ◽  
R. Rudin
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Healthcare Providers ◽  
Care Quality ◽  
Time Savings ◽  
And Training ◽  
Exchange Health Information

SummaryBackground: The ability to electronically exchange health information among healthcare providers holds enormous promise to improve care coordination and reduce costs. Provider-to-provider data exchange is an explicit goal of the American Recovery and Reinvestment Act of 2009 and may be essential for the long-term success of the Affordable Care Act of 2010. However, little is known about what factors affect clinicians’ usage of health information exchange (HIE) functionality.Objective: To identify factors that affect clinicians’ HIE usage - in terms of frequency of contributing data to and accessing data from aggregate patient records - and suggest policies for fostering its usage.Methods: We performed a qualitative study using grounded theory by interviewing clinician-users and HIE staff of one operational HIE which supported aggregate patient record functionality. Fifteen clinicians were interviewed for one hour each about what factors affect their HIE usage. Five HIE staff were asked about technology and training issues to provide context. Interviews were recorded, transcribed and analyzed. Recruitment excluded clinicians with little or no familiarity with the HIE and was restricted to one community and a small number of specialties.Results: Clinicians were motivated to access the HIE by perceived improvements in care quality and time savings, but their motivation was moderated by an extensive list of factors including gaps in data, workflow issues and usability issues. HIE access intensities varied widely by clinician. Data contribution intensities to the HIE also varied widely and were affected by billing concerns and time constraints.Conclusions: Clinicians, EHR and HIE product vendors and trainers should work toward integrating HIE into clinical workflows. Policies should create incentives for HIE organizations to assist clinicians in using HIE, develop measures of HIE contributions and accesses, and create incentives for clinicians to contribute data to HIEs.

Future Sustainability of the Florida Health Information Exchange

2013 ◽  
Vol 15 (3) ◽  
pp. 38-46
Author(s):  
Alice M. Noblin ◽  
Kendall Cortelyou-Ward
Keyword(s):  
Health Care ◽  
Information Sharing ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Care Industry ◽  
The State ◽  
Care Industry ◽  
Basic Services

Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act (ARRA) of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida was now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. Since then, the Florida HIE has begun to take shape and information sharing is occurring. The ARRA funding will end in 2014 and the Florida HIE must have a plan to survive into the future. This plan must address challenges such as the recruitment of new users, integration of new services, and ultimately long term sustainability.

scholarly journals Physician leadership and health information exchange: literature review

2019 ◽  
Vol 26 (1) ◽  
pp. e100080
Author(s):  
Michele L Heath ◽  
Tracy H Porter
Keyword(s):  
Literature Review ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Physician Leadership ◽  
The Us ◽  
Us Government ◽  
Physician Leaders ◽  
Use Stage

BackgroundNotwithstanding two decades of health information exchange (HIE) failures across the country, the US government has incorporated HIE into Meaningful Use Stage 2, which, in turn, has sparked renewed physicians’ interest in HIE.ObjectiveThe purpose of this paper was to conduct a literature review to understand how physician leadership might have assisted in supporting organisations in achieving HIE collaboration.MethodThe authors conducted a review of the literature about HIE and physician challenges from 2009 to present to identify peer-reviewed publications which might apply. Reviewers abstracted each publication for predetermined issues related to physician leadership. Themes were identified based on the literature findings.ResultsThe literature review demonstrated four important themes (physician leader characteristics) that can assist in bridging the gap and creating collaboration in an HIE. The themes found in this study were: trust among physicians, promote involvement and buy-in, infuse value proposition and competition.ConclusionThis paper contributes to the healthcare literature by conducting a literature review of the existing literature of surrounding HIE implementation and physician leaders. Specifically, we sought to gain insight into the change process and how physician leaders have demonstrated an impact on the process. This research is the first of its kind to synthesise leadership issues related to HIE and specifically explore the role of physician leader impact on HIE.

scholarly journals Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange

2018 ◽  
Vol 84 (1) ◽  
pp. 175-182 ◽  
Author(s):  
Teresa M. Bell ◽  
Dannielle Gilyan ◽  
Brian A. Moore ◽  
Joel Martin ◽  
Blessing Ogbemudia ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Intervention Program ◽  
Health Information Exchange ◽  
Regional Health ◽  
Violence Intervention ◽  
Term Evaluation

scholarly journals The Use of Health Information Exchange to Augment Patient Handoff in Long-Term Care: A Systematic Review

2018 ◽  
Vol 09 (04) ◽  
pp. 752-771 ◽  
Author(s):  
Clemens Kruse ◽  
Gabriella Marquez ◽  
Daniel Nelson ◽  
Olivia Palomares
Keyword(s):  
Patient Safety ◽  
Health Information ◽  
Information Exchange ◽  
Long Term Care ◽  
Health Information Exchange ◽  
Patient Handoff ◽  
Nursing Facility ◽  
Term Care ◽  
Care Facilities

Background Legislation aimed at increasing the use of a health information exchange (HIE) in healthcare has excluded long-term care facilities, resulting in a vulnerable patient population that can benefit from the improvement of communication and reduction of waste. Objective The purpose of this review is to provide a framework for future research by identifying themes in the long-term care information technology sector that could function to enable the adoption and use of HIE mechanisms for patient handoff between long-term care facilities and other levels of care to increase communication between providers, shorten length of stay, reduce 60-day readmissions, and increase patient safety. Methods The authors conducted a systematic search of literature through CINAHL, PubMed, and Discovery Services for Texas A&M University Libraries. Search terms used were (“health information exchange” OR “healthcare information exchange” OR “HIE”) AND (“long term care” OR “long-term care” OR “nursing home” OR “nursing facility” OR “skilled nursing facility” OR “SNF” OR “residential care” OR “assisted living”). Articles were eligible for selection if they were published between 2010 and 2017, published in English, and published in academic journals. All articles were reviewed by all reviewers and literature not relevant to the research objective was excluded. Results Researchers selected and reviewed 22 articles for common themes. Results concluded that the largest facilitator and barrier to the adoption of HIE mechanisms is workflow integration/augmentation and the organizational structure/culture, respectively. Other identified facilitator themes were enhanced communication, increased effectiveness of care, and patient safety. The additional barriers were missing/incomplete data, inefficiency, and market conditions. Conclusion The long-term care industry has been left out of incentives from which the industry could have benefited tremendously. Organizations that are not utilizing health information technology mechanisms, such as electronic health records and HIEs, are at a disadvantage as insurers switch to capitated forms of payment that rely on reduced waste to generate a profit.

scholarly journals Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs

2019 ◽  
Vol 26 (1) ◽  
pp. e000014
Author(s):  
Jennifer Herout ◽  
Donna Baggetta ◽  
Amanda Cournoyer ◽  
Aaron S Dietz ◽  
Jane Robbins ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
The United States ◽  
United States Department ◽  
Department Of Veterans Affairs ◽  
Multiple Data ◽  
Technical Issues ◽  
Data Source ◽  
System Errors

BackgroundThe promise of Health Information Exchange (HIE) systems rests in their potential to provide clinicians and administrative staff rapid access to relevant patient data to support judgement and decision-making. However, HIE systems can have usability and technical issues, as well as fail to support user workflow.ObjectiveShare the findings from a series of studies that address HIE system deficiencies for an Electronic Health Record (EHR) viewer which accesses multiple data sources.MethodsA variety of methods were used, in a series of studies, to gain a better understanding of issues and their mitigation through use of promising EHR viewer features.ResultsThe study series results are presented by the themes that underscore the importance for users to distinguish between data that are available but missing due to connection or system errors, data that are omitted entirely because they are not available and data that are excluded due to filtered search criteria.ConclusionsThe principal findings from this study series led to improvement recommendations for the EHR viewer, as well as citing areas that are ripe for further investigation and analysis.

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