Health information exchange in the wild: the association between organizational capability and perceived utility of clinical event notifications in ambulatory and community care.
Event notifications are real-time, electronic, automatic alerts to providers of their patients' health care encounters at other facilities. Our objective was to examine the effects of organizational capability and related social/organizational issues upon users' perceptions of the impact of event notifications on quality, efficiency, and satisfaction.



We surveyed representatives (n = 49) of 10 organizations subscribing to the Bronx Regional Health Information Organization's event notification services about organizational capabilities, notification information quality, perceived usage, perceived impact, and organizational and respondent characteristics. The response rate was 89%. Average item scores were used to create an individual domain summary score. The association between the impact of event notifications and organizational characteristics was modeled using random-intercept logistic regression models.



Respondents estimated that organizations followed up on the majority (83%) of event notifications. Supportive organizational policies were associated with the perception that event notifications improved quality of care (odds ratio [OR] = 2.12; 95% CI, = 1.05, 4.45), efficiency (OR = 2.06; 95% CI = 1.00, 4.21), and patient satisfaction (OR = 2.56; 95% CI = 1.13, 5.81). Higher quality of event notification information was also associated with a perceived positive impact on quality of care (OR = 2.84; 95% CI = 1.31, 6.12), efficiency (OR = 3.04; 95% CI = 1.38, 6.69), and patient satisfaction (OR = 2.96; 95% CI = 1.25, 7.03).



Health care organizations with appropriate processes, workflows, and staff may be better positioned to use event notifications. Additionally, information quality remains critical in users' assessments and perceptions.
Department of Health Care Policy and Management, Indiana University Richard M Fairbanks School of Public Health at IUPUI joshvest@iu.edu.|Regenstrief Institute, Inc. Indianapolis, IN, USA.
Joshua R
JR
Vest
Department of Healthcare Policy & Research Division of Health Informatics, Weill Cornell Medical College, 425 E 61st St, Suite 301, New York, NY 10065, USA.
Jessica S
JS
Ancker
D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D003142:Communication; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D066275:Health Information Exchange; D063025:Health Information Management; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D011795:Surveys and Questionnaires