scholarly journals Interoperable Electronic Health Records and Health Information Exchanges: Systematic Review

10.2196/12607 ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e12607 ◽  
Author(s):  
Mark J Dobrow ◽  
Jessica P Bytautas ◽  
Sukirtha Tharmalingam ◽  
Simon Hagens
2018 ◽  
Author(s):  
Mark J Dobrow ◽  
Jessica P Bytautas ◽  
Sukirtha Tharmalingam ◽  
Simon Hagens

BACKGROUND As the availability of interoperable electronic health records (iEHRs) or health information exchanges (HIEs) continues to increase, there is greater need and opportunity to assess the current evidence base on what works and what does not regarding the adoption, use, and impact of iEHRs. OBJECTIVE The purpose of this project is to assess the international evidence base on the adoption, use, and impact of iEHRs. METHODS We conducted a systematic review, searching multiple databases—MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)—with supplemental searches conducted in Google Scholar and grey literature sources (ie, Google, Grey Literature Report, and OpenGrey). All searches were conducted in January and February 2017. Articles were eligible for inclusion if they were published in English, were published from 2006 to 2017, and were either an original research study or a literature review. In order to be included, articles needed to focus on iEHRs and HIEs across multiple health care settings, as well as on the impact and effectiveness of iEHR adoption and use. RESULTS We included 130 articles in the synthesis (113 primary studies, 86.9%; 17 reviews, 13.1%), with the majority focused on the United States (88/130, 67.7%). The primary studies focused on a wide range of health care settings; the three most prevalent settings studied included acute care (59/113, 52.2%), primary care (44/113, 38.9%), and emergency departments (34/113, 30.1%). We identified 29 distinct measurement items in the 113 primary studies that were linked to 522 specific measurement outcomes. Productivity and quality were the two evaluation dimensions that received the most attention, accounting for 14 of 29 (48%) measurement items and 306 of 522 (58.6%) measurement outcomes identified. Overall, the majority of the 522 measurement outcomes were positive (298/522, 57.1%). We also identified 17 reviews on iEHR use and impact, 6 (35%) that focused on barriers and facilitators to adoption and implementation and 11 (65%) that focused on benefits and impacts, with the more recent reviews finding little generalizable evidence of benefit and impact. CONCLUSIONS This review captures the status of an evolving and active field focused on the use and impact of iEHRs. While the overall findings suggest many positive impacts, the quality of the primary studies were not evaluated systematically. When broken down by specific measurement item, the results directed attention both to measurement outcomes that were consistently positive and others that were mostly negative or equivocal.


2013 ◽  
Vol 9 (4) ◽  
pp. 177-189 ◽  
Author(s):  
Charles R. Denham ◽  
David C. Classen ◽  
Stephen J. Swenson ◽  
Michael J. Henderson ◽  
Thomas Zeltner ◽  
...  

2015 ◽  
Vol 26 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Paolo Campanella ◽  
Emanuela Lovato ◽  
Claudio Marone ◽  
Lucia Fallacara ◽  
Agostino Mancuso ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031373 ◽  
Author(s):  
Jennifer Anne Davidson ◽  
Amitava Banerjee ◽  
Rutendo Muzambi ◽  
Liam Smeeth ◽  
Charlotte Warren-Gash

IntroductionCardiovascular diseases (CVDs) are among the leading causes of death globally. Electronic health records (EHRs) provide a rich data source for research on CVD risk factors, treatments and outcomes. Researchers must be confident in the validity of diagnoses in EHRs, particularly when diagnosis definitions and use of EHRs change over time. Our systematic review provides an up-to-date appraisal of the validity of stroke, acute coronary syndrome (ACS) and heart failure (HF) diagnoses in European primary and secondary care EHRs.Methods and analysisWe will systematically review the published and grey literature to identify studies validating diagnoses of stroke, ACS and HF in European EHRs. MEDLINE, EMBASE, SCOPUS, Web of Science, Cochrane Library, OpenGrey and EThOS will be searched from the dates of inception to April 2019. A prespecified search strategy of subject headings and free-text terms in the title and abstract will be used. Two reviewers will independently screen titles and abstracts to identify eligible studies, followed by full-text review. We require studies to compare clinical codes with a suitable reference standard. Additionally, at least one validation measure (sensitivity, specificity, positive predictive value or negative predictive value) or raw data, for the calculation of a validation measure, is necessary. We will then extract data from the eligible studies using standardised tables and assess risk of bias in individual studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data will be synthesised into a narrative format and heterogeneity assessed. Meta-analysis will be considered when a sufficient number of homogeneous studies are available. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation tool.Ethics and disseminationThis is a systematic review, so it does not require ethical approval. Our results will be submitted for peer-review publication.PROSPERO registration numberCRD42019123898


Sign in / Sign up

Export Citation Format

Share Document