Health Information Exchange: Navigating and Managing a Network of Health Information Systems, Second Edition, now fully updated, is a practical guide on how to understand, manage and make use of a health information exchange infrastructure, which moves patient-centered information within the health care system. The book informs and guides the development of new infrastructures as well as the management of existing and expanding infrastructures across the globe. Sections explore the reasons for the health information exchange (HIE) infrastructures, how to manage them, examines the key drivers of HIE, and barriers to their widespread use. In addition, the book explains the underlying technologies and methods for conducting HIE across communities as well as nations. Finally, the book explains the principles of governing an organization that chiefly moves protected health information around. The text unravels the complexities of HIE and provides guidance for those who need to access HIE data and support operations. Encompasses comprehensive knowledge on the technology and governance of health information exchanges (HIEs) Presents business school style case studies that explore why a given HIE has or hasn't been successful Discusses the kinds of data and practical examples of the infrastructure required to exchange clinical data to support modern medicine in a world of disparate EHR systems
Has the Health Information Exchange HIE work been fairly and/or equitably divided and delegated among team members who are qualified and capable to perform the work? Has everyone contributed? What is our Health Information Exchange HIE Strategy? What is the total cost related to deploying Health Information Exchange HIE, including any consulting or professional services? What are the compelling business reasons for embarking on Health Information Exchange HIE? Does our organization need more Health Information Exchange HIE education? Defining, designing, creating, and implementing a process to solve a challenge or meet an objective is the most valuable role... In EVERY group, company, organization and department. Unless you are talking a one-time, single-use project, there should be a process. Whether that process is managed and implemented by humans, AI, or a combination of the two, it needs to be designed by someone with a complex enough perspective to ask the right questions. Someone capable of asking the right questions and step back and say, 'What are we really trying to accomplish here? And is there a different way to look at it?' This Self-Assessment empowers people to do just that - whether their title is entrepreneur, manager, consultant, (Vice-)President, CxO etc... - they are the people who rule the future. They are the person who asks the right questions to make Health Information Exchange HIE investments work better. This Health Information Exchange HIE All-Inclusive Self-Assessment enables You to be that person. All the tools you need to an in-depth Health Information Exchange HIE Self-Assessment. Featuring 700 new and updated case-based questions, organized into seven core areas of process design, this Self-Assessment will help you identify areas in which Health Information Exchange HIE improvements can be made. In using the questions you will be better able to: - diagnose Health Information Exchange HIE projects, initiatives, organizations, businesses and processes using accepted diagnostic standards and practices - implement evidence-based best practice strategies aligned with overall goals - integrate recent advances in Health Information Exchange HIE and process design strategies into practice according to best practice guidelines Using a Self-Assessment tool known as the Health Information Exchange HIE Scorecard, you will develop a clear picture of which Health Information Exchange HIE areas need attention. Your purchase includes access details to the Health Information Exchange HIE self-assessment dashboard download which gives you your dynamically prioritized projects-ready tool and shows your organization exactly what to do next. You will receive the following contents with New and Updated specific criteria: - The latest quick edition of the book in PDF - The latest complete edition of the book in PDF, which criteria correspond to the criteria in... - The Self-Assessment Excel Dashboard, and... - Example pre-filled Self-Assessment Excel Dashboard to get familiar with results generation ...plus an extra, special, resource that helps you with project managing. INCLUDES LIFETIME SELF ASSESSMENT UPDATES Every self assessment comes with Lifetime Updates and Lifetime Free Updated Books. Lifetime Updates is an industry-first feature which allows you to receive verified self assessment updates, ensuring you always have the most accurate information at your fingertips.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Health information exchange (HIE) is the electronic exchange of patient medical records among hospitals. I investigate how two defining characteristics of HIE can cause under-adoption. First, HIE represents an information-sharing network, and participation for any hospital is valuable if others participate. This is a network effect. Second, HIE involves exchange of medical records, which may be competitive assets for hospitals. Therefore, hospitals may have disincentive to exchange with competitors despite social benefits. This is a competitive effect. I present a theoretical framework of hospitals' decisions to adopt HIE and show how presence of network and competitive effects can result in under-adoption relative to the social optimal. I then test for evidence of network and competitive effects in hospital HIE adoption. In the empirical analysis, I use two measure of HIE adoption. The first is a measure of general adoption in which all hospitals that have adopted any HIE capability are assumed to be able to exchange information with each other. The second takes into account that much information-sharing occurs through interoperable IT systems and currently, most IT systems of different vendors are not interoperable. I find evidence of network effects in general HIE adoption and vendor choice. I find that a 10% increase in market adoption rate results in a hospital being 9.2% more likely to adopt HIE. I also find that a 10% increase in adoption rate of a vendor results in a hospital being 1.5% more likely to adopt the vendor. I also find evidence of competitive effects. Specifically, hospitals that are more vulnerable to losing market share are less likely to adopt a prominent vendor in a market. I estimate a model of patients' hospital preferences and hospitals' HIE adoption decision. Through counterfactual simulation, I show effects of widespread HIE adoption on market share redistribution. Finally, I evaluate current policies such as the federal government's $30 billion adoption incentive program (HITECH Act). The program may be inadequate to promote widespread interoperability in the presence of competitive effects. I also discuss the implications of network effects for competition and innovation in the health IT industry.
A practice-based guide to applying the principles of human-centered design to real-world health challenges; updated and expanded with post–COVID-19 innovations. This book offers a practice-based guide to applying the principles of human-centered design to real-world health challenges that range from drug packaging to breast cancer detection. Written by pioneers in the field—Bon Ku, a physician leader in innovative health design, and Ellen Lupton, an award-winning graphic designer—the book outlines the fundamentals of design thinking and highlights important products, prototypes, and research in health design. This revised and expanded edition describes innovations developed in response to the COVID-19 crisis, including an intensive care unit in a shipping container, a rolling cart with intubation equipment, and a mask brace that gives a surgical mask a tighter seal. The book explores the special overlap of health care and the creative process, describing the development of such products and services as a credit card–sized device that allows patients to generate their own electrocardiograms; a mask designed to be worn with a hijab; improved emergency room signage; and a map of racial disparities and COVID-19. It will be an essential volume for health care providers, educators, patients, and designers who seek to create better experiences and improved health outcomes for individuals and communities.
Advances in health information technology (health IT) have the potential to improve the quality of healthcare, to increase the availability of health information for treatment, and to implement safeguards that cannot be applied easily or cost-effectively to paper-based health records. However, the digitization of health information is also raising new privacy risks and concerns. Sensitive health information in digital form is more easily aggregated, used, and shared. In addition, the rising cost of healthcare and the search for efficiency may create incentives to use the information in new ways. Research has consistently shown that while the public sees the potential value of health information exchange and technological advancements, it remains gravely concerned about the privacy of their sensitive health information. As a result, it is becoming increasingly clear that ensuring public trust will be critical to the successful implementation of nationwide health information exchange. The purpose of this second edition is two-fold: 1) to educate readers about privacy concepts and 2) highlight key privacy issues facing the nation and the healthcare community as it moves towards electronic health records and health information exchange. The first three chapters are descriptive in nature, defining privacy and distinguishing it from security, defining the complex legal landscape for health information privacy, and setting the stage for the following chapters by describing the current landscape of the evolving healthcare environment. The following chapters discuss specific privacy issues and challenges in detail. The book concludes with a chapter providing a view to the future of healthcare and the association privacy implications. This is an updated version of one of HIMSS’ best-selling books on information privacy.
This 3rd edition of a classic textbook examines the context and background of public health informatics, explores the technology and science underlying the field, discusses challenges and emerging solutions, reviews many key public health information systems, and includes practical, case-based studies to guide the reader through the topic. The editors have expanded the text into new areas that have become important since publication of the previous two editions due to changing technologies and needs in the field, as well as updating and augmenting much of the core content. The book contains learning objectives, overviews, future directions, and review questions to assist readers to engage with this vast topic. The Editors and their team of well-known contributors have built upon the foundation established by the previous editions to provide the reader with a comprehensive and forward-looking review of public health informatics. The breadth of material in Public Health Informatics and Information Systems, 3rd edition makes it suitable for both undergraduate and graduate coursework in public health informatics, enabling instructors to select chapters that best fit their students’ needs.
This thoroughly revised and updated second edition of Operations Management in Healthcare: Strategy and Practice describes how healthcare organizations can cultivate a competitive lead by developing superior operations using a strategic perspective. In clearly demonstrating the "how-tos" of effectively managing a healthcare organization, this new edition also addresses the "why" of providing quality and value-based care. Comprehensive and practice-oriented, chapters illustrate how to excel in the four competitive priorities - quality, cost, delivery, and flexibility - in order to build a cumulative model of healthcare operations in which all concepts and tools fit together. This textbook encourages a hands-on approach and integrates mind maps to connect concepts, icons for quick reference, dashboards for measurement and tracking of progress, and newly updated end-of-chapter problems and assignments to reinforce creative and critical thinking. Written with the diverse learning needs in mind for programs in health administration, public health, business administration, public administration, and nursing, the textbook equips students with essential high-level problem-solving and process improvement skills. The book reveals concepts and tools through a series of short vignettes of a fictitious healthcare organization as it embarks on its journey to becoming a highly reliable organization. This second edition also includes a strong emphasis on the patient's perspective as well as expanded and added coverage of Lean Six Sigma, value-based payment models, vertical integration, mergers and acquisitions, artificial intelligence, population health, and more to reflect evolving innovations in the healthcare environment across the United States. Complete with a full and updated suite of Instructor Resources, including Instructor’s Manual, PowerPoints, and test bank in addition to data sets, tutorial videos, and Excel templates for students. Key Features: Demonstrates the "how-tos" of effectively managing a healthcare organization Sharpens problem-solving and process improvement skills through use of an extensive toolkit developed throughout the text Prepares students for Lean Six Sigma certification with expanded coverage of concepts, tools, and analytics Highlights new trends in healthcare management with coverage of value-based payments, mergers and acquisitions, population health, telehealth, and more Intertwines concepts with vivid vignettes to describe human dynamics, organizational challenges, and applications of tools Employs boxed features and YouTube videos to address frequently asked questions and real-world instances of operations in practice
OBJECTIVES: This review sought to systematically review the available literature on health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations. HIE has been promoted as an important application of technology in medicine that can improve the efficiency, cost-effectiveness, quality, and safety of health care delivery. However, HIE also requires considerable investment by sponsors, which have included governments as well as health care organizations. This review aims to synthesize the currently available research addressing HIE effectiveness, use, usability, barriers and facilitators to actual use, implementation, and sustainability, and to present this information as a foundation on which future implementation, expansion, and research can be based. DATA SOURCES: A research librarian designed and conducted searches of electronic databases, including MEDLINE(r) (1990 to February 2015), PsycINFO(r) (1990 to February 2015), CINAHL(r) (1990 through February 2015), the Cochrane Central Register of Controlled Trials (through January 2015), the Cochrane Database of Systematic Reviews (through January 2015), the Database of Abstracts of Reviews of Effects (through the first quarter of 2015), and the National Health Sciences Economic Evaluation Database (through the first quarter of 2015). The searches were supplemented by reviewing reference lists and the table of contents of journals not indexed in the databases we searched. REVIEW METHODS: Two investigators reviewed abstracts and the selected full-text articles for inclusion based on predefined criteria. Discrepancies were resolved through discussion and consensus, with a third investigator making the final decision as needed. Data were abstracted from each included article by one person and verified by another. All analyses were qualitative, and they were customized according to the topic. RESULTS: We included 136 studies overall, with 34 on effectiveness, 26 of which reported intermediate clinical, economic, or patient outcomes, and 8 that reported on clinical perceptions of HIE. We also found 58 studies on the use of HIE, 22 on usability and other facilitators and barriers to actual use of HIE, 45 on facilitators or barriers to HIE implementation, and 17 on factors related to sustainability of HIE. No studies of HIE effectiveness reported impact on primary clinical outcomes (e.g., mortality and morbidity) or identified harms. Low-quality evidence somewhat supports the value of HIE for reducing duplicative laboratory and radiology test ordering, lowering emergency department costs, reducing hospital admissions (less so for readmissions), improving public health reporting, increasing ambulatory quality of care, and improving disability claims processing. In studies of clinician perceptions of HIE, most respondents attributed positive changes to HIE, such as improvements in coordination, communication, and knowledge about the patient. However in one study clinicians reported that the HIE did not save time and may not be worth the cost. Studies of HIE use found that HIE adoption has increased over time, with 76 percent of U.S. hospitals exchanging information in 2014, an 85-percent increase since 2008 and a 23-percent increase since 2013. HIE systems were used by 38 percent of office-based physicians in 2012, while use remains low, less than 1 percent, among long-term care providers. Within organizations with HIE, the number of users or the number of visits in which the HIE was used was generally very low. The degree of usability of an HIE was associated with increased rates of use but was not associated with effectiveness outcomes. The most commonly cited barriers to HIE use were lack of critical mass electronically exchanging data, inefficient workflow, and poorly designed interface and update features. Information was insufficient to allow us to assess usability by HIE function or architecture. Studies provided information on both external environmental and internal organizational characteristics that affect implementation and sustainability. General characteristics of the HIE organization (e.g., strong leadership) or specific characteristics of the HIE system were the most frequently cited facilitators, while disincentives such as competition or lack of a business case for HIE were the most frequently identified barriers. LIMITATIONS: The scope of studies identified was limited compared with the actual uses and capabilities of HIE. The outcomes measured and methods of measurement and analysis, for example, were limited and narrowly defined; the issue of potential confounders was not addressed in most studies of effectiveness, and harms were not adequately studied. There was a high degree of heterogeneity in study designs, outcomes, HIE types, and settings across the studies, limiting the ability to synthesize the evidence; no quantitative analyses were possible. The applicability of this evidence base is uncertain because the HIE systems studied were so diverse, and many in existence have not contributed to research in this field. CONCLUSIONS: The full impact of HIE on clinical outcomes and potential harms is inadequately studied, although evidence provides some support for benefit in reducing use of some specific resources and achieving improvements in quality-of-care measures. Use of HIE has risen over time, and is highest in hospitals and lowest in long-term care settings. However, use of HIE within organizations that offer it is still low. Barriers to HIE use include lack of critical mass participating in the exchange, inefficient workflow, and poorly designed interface and update features. Studies have identified numerous facilitators and barriers to implementation and sustainability, but the studies have not ranked or compared their impact. To advance our understanding of HIE, future studies need to address comprehensive questions, use more rigorous designs, use a standard for describing types of HIE, and be part of a coordinated systematic approach to studying HIE.
