title: How could health information exchange better meet the needs of care practitioners?
abstract: BACKGROUND
  Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high.
  
  
  OBJECTIVE
  We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners.
  
  
  METHODS
  We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State.
  
  
  RESULTS
  The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows.
  
  
  CONCLUSIONS
  Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.
authors.affiliation: University of Copenhagen, Department of Computer Science , København S, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Kierkegaard
authors.affiliation: Department of Healthcare Policy and Research, Center for Healthcare Informatics and Policy, Weill Cornell Medical College , New York, USA , Health Information Technology Evalution Collaborative (HITEC), New York, USA.
authors.forename: R
authors.initials: R
authors.lastname: Kaushal
authors.affiliation: Weill Cornell Medical College , Department of Healthcare Policy and Research, New York, New York, United States.
authors.forename: J R
authors.initials: JR
authors.lastname: Vest
mesh_terms: D032962:Consent Forms; D066275:Health Information Exchange; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D005791:Patient Care; D015397:Program Evaluation; D057188:Workflow
keywords: Health information exchange; community; consent model; evaluation studies; information systems