An Indiana University Richard M. Fairbanks School of Public Health – Indianapolis researcher is conducting the first study to discover if patients are less likely to be hospitalized if emergency departments have access to their complete medical record via health information exchange.
[Photo: Dr. Brian E. Dixon]
Supported by a two-year $296,587 award from the Agency for Healthcare Research and Quality, the study examines health information exchange use over multiple years to evaluate whether it improves patient outcomes in emergency departments. The innovative work will measure actual use of health information exchange over time, across multiple institutions, to generate high-quality evidence of the value and benefit of health information exchange, or HIE, in the delivery of emergency care.
“Findings from our new study could serve as a report card on potential benefits of HIE and as a template for HIEs as they mature,” said Fairbanks School of Public Health investigator Dr. Brian E. Dixon, an assistant professor of epidemiology and principal investigator of the new study.
Health information exchange is more frequently used in emergency settings than anywhere else in the health care system. Yet little research has been done on its long-term use – or its impact on patient care – in the emergency setting, where visits are unplanned, urgent and acute, and patient health information is not available beforehand to care providers.
While researchers have previously investigated whether the availability of information from HIE reduces costs by decreasing duplicate testing and unneeded imaging studies, there is a dearth of knowledge about whether providers’ use of health information exchange in the emergency department leads to actual improvements in patient outcomes. There is also limited existing information on which personnel in an emergency department use HIE and why those providers choose to do so.
The investigators will review usage logs from the Indiana Network for Patient Care, one of the largest interorganizational clinical data repositories in the country, to determine how frequently information from the HIE was used in the emergency department, for what kinds of patients, by what types of health care providers and under what conditions it was most useful. They will also determine which sections of patient medical records – for example, laboratory results, imaging studies, medication list or medical history – were accessed. In addition, they will review the outcome of the visit to determine whether the patient was admitted to the hospital.
“In today’s world, surrounded by technology and the promise of self-driving cars, it is hard to believe that clinical data is still hard to come by,” said Regenstrief Institute investigator Dr. J.T. Finnell, an Indiana University School of Medicine associate professor of emergency medicine. “It is a common struggle to gather and mine the data to make informed decisions regarding patient care. Having access to the entire patient record only makes sense, and it’s aligned with existing patient expectations.”
Dr. Finnell is a co-investigator on the Agency for Healthcare Research and Quality-supported project, along with Dr. Joshua Vest, of the Fairbanks School of Public Health and Dr. Saurabh Rahurkar, of the Regenstrief Institute.