title: Use patterns of health information exchange through a multidimensional lens: conceptual framework and empirical validation.
abstract: Insights about patterns of system use are often gained through the analysis of system log files, which record the actual behavior of users. In a clinical context, however, few attempts have been made to typify system use through log file analysis. The present study offers a framework for identifying, describing, and discerning among patterns of use of a clinical information retrieval system. We use the session attributes of volume, diversity, granularity, duration, and content to define a multidimensional space in which each specific session can be positioned. We also describe an analytical method for identifying the common archetypes of system use in this multidimensional space. We demonstrate the value of the proposed framework with a log file of the use of a health information exchange (HIE) system by physicians in an emergency department (ED) of a large Israeli hospital. The analysis reveals five distinct patterns of system use, which have yet to be described in the relevant literature. The results of this study have the potential to inform the design of HIE systems for efficient and effective use, thus increasing their contribution to the clinical decision-making process.
authors.affiliation: Department of Industrial Engineering & Management, Ben-Gurion University of the Negev, Israel. Electronic address: liranpo@post.bgu.ac.il.
authors.forename: Liran
authors.initials: L
authors.lastname: Politi
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Codish
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Israel.
authors.forename: Iftach
authors.initials: I
authors.lastname: Sagy
authors.affiliation: Department of Industrial Engineering & Management, Ben-Gurion University of the Negev, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Fink
mesh_terms: D000046:Academic Medical Centers; D016000:Cluster Analysis; D004636:Emergency Service, Hospital; D066275:Health Information Exchange / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D008962:Models, Theoretical
keywords: Health information exchange; Log file; Multidimensional analysis; Use pattern