title: What should we measure? Conceptualizing usage in health information exchange.
abstract: Under the provisions of the Health Information Technology for Economic & Clinical Health act providers need to demonstrate their 'meaningful use' of electronic health record systems' health information exchange (HIE) capability. HIE usage is not a simple construct, but the choice of its measurement must attend to the users, context, and objectives of the system being examined. This review examined how usage is reported in the existing literature and also what conceptualizations of usage might best reflect the nature and objectives of HIE. While existing literature on HIE usage included a diverse set of measures, most were theoretically weak, did not attend to the interplay of measure, level of analysis and architectural strategy, and did not reflect how HIE usage affected the actual process of care. Attention to these issues will provide greater insight into the effects of previously inaccessible information on medical decision-making and the process of care.
authors.affiliation: Department of Health Policy & Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas 77843, USA. jrvest@srph.tamhsc.edu
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
authors.forename: Jon
authors.initials: J
authors.lastname: Jasperson
mesh_terms: D057286:Electronic Health Records; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data*; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D014481:United States