Dullabh Prashila, Hovey Lauren
NORC at the University of Chicago, United States.
Stud Health Technol Inform. 2013;192:613-7.
There is widespread consensus that Health Information Exchange, the electronic sharing of patients' health information between delivery settings, is critical to improving the quality and efficiency of patient care. The United States has had limited success in establishing broad-based HIE. To address these issues, the federal government funded the State Health Information Exchange Cooperative Agreement Program. An in-depth qualitative study was conducted, consisting of site visits and semi-structured discussions with 105 respondents in 5 states to understand early HIE implementation experiences. Results show the last two years have seen unprecedented growth in HIE infrastructure. Key factors such as maturity of HIE at baseline and healthcare market characteristics have shaped governance models and technical infrastructures. Early focus on stakeholder value proposition and sustainability planning is critical for long-term success. States continue to face numerous challenges in converting stakeholder support into financial commitment and real-time exchange of health information. We discuss the key issues states faced in attempting to realize broad-based HIE and offer insights that may assist other states.
人们普遍认为，健康信息交换，即医疗机构之间对患者健康信息进行电子共享，对于提高患者护理质量和效率至关重要。美国在建立广泛的健康信息交换方面成效有限。为解决这些问题，联邦政府资助了州健康信息交换合作协议项目。开展了一项深入的定性研究，包括实地考察以及与5个州的105名受访者进行半结构化讨论，以了解健康信息交换早期实施的经验。结果显示，在过去两年中，健康信息交换基础设施实现了前所未有的增长。诸如基线时健康信息交换的成熟度和医疗保健市场特征等关键因素塑造了治理模式和技术基础设施。早期关注利益相关者价值主张和可持续性规划对于长期成功至关重要。各州在将利益相关者的支持转化为财政承诺以及健康信息的实时交换方面仍面临诸多挑战。我们讨论了各州在试图实现广泛的健康信息交换时面临的关键问题，并提供了可能有助于其他州的见解。
