title: Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey.
abstract: BACKGROUND
  The trend towards hospitalist medicine can lead to disjointed patient care. Outpatient clinicians may be unaware of patients' encounters with a disparate healthcare system. Electronic notifications to outpatient clinicians of patients' emergency department (ED) visits and inpatient admissions and discharges using health information exchange can inform outpatient clinicians of patients' hospital-based events.
  
  
  OBJECTIVE
  Assess outpatient clinicians' impressions of a new, secure messaging-based, patient event notification system.
  
  
  METHODS
  Twenty outpatient clinicians receiving notifications of hospital-based events were recruited and 14 agreed to participate. Using a semi-structured interview, clinicians were asked about their use of notifications and the impact on their practices.
  
  
  RESULTS
  Nine of 14 interviewed clinicians (64%) thought that without notifications, they would have heard about fewer than 10% of ED visits before the patient's next visit. Nine clinicians (64%) thought that without notifications, they would have heard about fewer than 25% of inpatient admissions and discharges before the patient's next visit. Six clinicians (43%) reported that they call the inpatient team more often because of notifications. Eight users (57%) thought that notifications improved patient safety by increasing their awareness of the patients' clinical events and their medication changes. Key themes identified were the importance of workflow integration and a desire for more clinical information in notifications.
  
  
  CONCLUSIONS
  The notification system is perceived by clinicians to be of value. These findings should instigate further message-oriented use of health information exchange and point to refinements that can lead to even greater benefits.
authors.affiliation: Department of Medical Informatics, Oregon Health & Science University, OR, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Altman
authors.forename: Jason S
authors.initials: JS
authors.lastname: Shapiro
authors.forename: Thomas
authors.initials: T
authors.lastname: Moore
authors.forename: Gilad J
authors.initials: GJ
authors.lastname: Kuperman
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011320:Primary Health Care