title: Improving integrated care in chronic kidney failure patients with a standard-based interoperability framework.
abstract: This paper introduces the evaluation report after fostering a Standard-based Interoperability Framework (SIF) between the Virgen del Rocío University Hospital (VRUH) Haemodialysis (HD) Unit and 5 outsourced HD centres in order to improve integrated care by automatically sharing patients' Electronic Health Record (EHR) and lab test reports. A pre-post study was conducted during fourteen months. The number of lab test reports of both emergency and routine nature regarding to 379 outpatients was computed before and after the integration of the SIF. Before fostering SIF, 19.38 lab tests per patient were shared between VRUH and HD centres, 5.52 of them were of emergency nature while 13.85 were routine. After integrating SIF, 17.98 lab tests per patient were shared, 3.82 of them were of emergency nature while 14.16 were routine. The inclusion of a SIF in the HD Integrated Care Process has led to an average reduction of 1.39 (p=0.775) lab test requests per patient, including a reduction of 1.70 (p=0.084) in those of emergency nature, whereas an increase of 0.31 (p=0.062) was observed in routine lab tests. Fostering this strategy has led to the reduction in emergency lab test requests, which implies a potential improvement of the integrated care.
authors.affiliation: Technological Innovation Group, "Virgen del Rocío" University Hospital, Seville, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Núñez-Benjumea
authors.affiliation: Technological Innovation Group, "Virgen del Rocío" University Hospital, Seville, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Moreno-Conde
authors.affiliation: Technological Innovation Group, "Virgen del Rocío" University Hospital, Seville, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Jódar-Sánchez
authors.affiliation: Technological Innovation Group, "Virgen del Rocío" University Hospital, Seville, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Martínez-García
authors.affiliation: Innovation Technology in "Virgen Macarena" and "Virgen del Rocío" University Hospitals, Seville, Spain.
authors.forename: Carlos L
authors.initials: CL
authors.lastname: Parra-Calderón
mesh_terms: D002984:Clinical Laboratory Information Systems / Q000592:standards*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D057286:Electronic Health Records / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008498:Medical Record Linkage / Q000592:standards*; D058996:Quality Improvement / Q000592:standards*; D006435:Renal Dialysis / Q000592:standards*; D013030:Spain