Research: HIE Policies Such as Automatic Query, Patient Consent, Help Increase Volume of Data Exchanged | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Research: HIE Policies Such as Automatic Query, Patient Consent, Help Increase Volume of Data Exchanged

June 16, 2016
by Rajiv Leventhal
| Reprints

Automatic querying and limited consent requirements are organizational health information exchange (HIE) policy decisions that impact the volume of exchange, and ultimately the information available to providers, according to new research published in the Journal of the American Medical Informatics Association.

Researchers from the Stanford University School of Medicine, University of Michigan, and elsewhere, looked at data on organization-level HIE policy decisions and their impact on HIE volume from a diverse set of healthcare systems using the same electronic health record (EHR)-based HIE platform. The study focused on clinical summary exchange over a two-year period. The researchers wanted to answer:

  • What proportion of organizations chose to engage in automatic querying and what is the associated impact on volume of clinical summary exchange?
  • When automatic querying is enabled, what proportion of patient linkages are established automatically (representing information at another institution that the provider did not know to seek) vs manually (representing information the provider knew to seek)?
  • What proportion of organizations chose not to require patient consent for HIE and what is the associated impact on volume of clinical summary exchange?

“Understanding the impact of local organizational HIE policy decisions on the volume of exchange activity is important in ensuring that future efforts to promote HIE will consider these decisions. Without sufficient attention to these critical policies, technical interoperability may not translate into availability of needed health information for clinicians at the point of care,” the researchers noted.

For the study, the researchers looked at the Northern California HIE Collaborative and 11 of its systems. Nine of the 11 provider organizations (82 percent) enabled automatic querying during the study period. Consent decisions were more varied. Four of the 11 provider organizations (36 percent) required point-of-care patient authorization, one (9 percent) required authorization if a patient had a prior encounter in a confidential department (eg, mental health), and six organizations (54 percent) did not require any HIE-specific authorization, according to the research.

A total of 6,909,416 clinical summaries were retrieved by participating organizations within the regional HIE network over the time frame of the study. In January 2013, six organizations were participating and retrieved 57,000 clinical summaries. By February 2015, all 11 organizations were participating and retrieved 826,000 clinical summaries, representing a 1,349 percent increase in exchange volume.

Indeed, the initiation of auto-query resulted in a significant increase in the monthly volume of clinical summaries received. In the pre auto-query period, exchange volume increased by 635 summaries per month. In the post auto-query period, exchange volume increased by nearly 10,000 summaries per month.

Meanwhile, provider organizations that required consent experienced a marginally statistically significant increase in clinical summary exchange volume of 510 summaries per month. Provider organizations that did not require consent experienced a significantly greater increase of 4,571 summaries per month. While no consent organizations started at a lower exchange volume overall, after six months they surpassed the consent organizations. Results were similar when we limited the data to the post auto-query period.

The researchers concluded, ” Specifically, both enabling automated patient record querying and information retrieval and minimizing patient consent processes appeared to substantially increase exchange volume. Perhaps most critical is our finding that auto-query identifies a large volume of information that was not sought out manually, suggesting that providers either did not know about this information, did not have the time to retrieve it, or did not consider it to be clinically relevant. These findings highlight that local organizational policy decisions have a significant impact on the extent to which information is available to clinicians to support decision-making.”

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Study will Leverage Connecticut HIE to Help Prevent Suicides

A new study will aim to leverage CTHealthLink, a physician-led health information exchange (HIE) in Connecticut, to help identify the factors leading to suicide and to ultimately help prevent those deaths.

Duke Health First to Achieve HIMSS Stage 7 Rating in Analytics

North Carolina-based Duke Health has become the first U.S. healthcare institution to be awarded the highest honor for analytic capabilities by HIMSS Analytics.

NIH Releases First Dataset from Adolescent Brain Development Study

The National Institutes of Health (NIH) announced the release of the first dataset from the Adolescent Brain Cognitive Development (ABCD) study, which will enable scientists to conduct research on the many factors that influence brain, cognitive, social, and emotional development.

Boston Children's Accelerates Data-Driven Approach to Clinical Research

In an effort to bring a more data-driven approach to clinical research, Boston Children’s Hospital has joined the TriNetX global health research network.

Paper Records, Films Most Common Type of Healthcare Data Breach, Study Finds

Despite the high level of hospital adoption of electronic health records and federal incentives to do so, paper and films were the most frequent location of breached data in hospitals, according to a recent study.

AHA Appoints Senior Advisor for Cybersecurity and Risk

The American Hospital Association (AHA) has announced that John Riggi has joined the association as senior advisor for cybersecurity and risk.