Department of Information Systems and Business Analytics, College of Business, Florida International University (FIU), Modesto A. Maidique Campus, 11200 S.W. 8th St, Miami, FL 33199, United States.
Int J Med Inform. 2023 Sep;177:105156. doi: 10.1016/j.ijmedinf.2023.105156. Epub 2023 Jul 21.
Hospitals may adopt various information transmission methods to participate in health information exchange (HIE) programs. However, even if they adopt multiple mechanisms, they may not actively use all of them to send inside information. This study analyzes the frequently used methods for sending data and the common barriers blocking sending practices in hospital settings.
Our sample included 3,015 community hospitals that reported their methods of sending patient health information in the 2019 American Hospital Association Information Technology Supplement Survey. The relationship between obstacles hospitals experienced and their use of the information-sending method was analyzed by using robust Poisson regression models.
Many-to-many exchanges that involve intermediaries such as a health information service provider (HISP), electronic health record (EHR) vendor-based network, and national network, once adopted, were more often used by hospitals than one-to-one exchange methods such as provider portals and direct access to EHR by login credentials. Hospitals that lacked the technical capability to electronically send patient health information were less likely to use any of the methods (p <.01), while hospitals located in a more concentrated market were more likely to send information to outside providers by using provider portal, interface connection and national network (p <.01).
There is still a notable gap between hospitals' adoption and the actual use of different HIE methods to send inside information to outside organizations. Results argue that even if hospitals adopted an HIE method, they might not necessarily participate in the actual sharing of information, and the method may remain unused due to several usage barriers.
Hospital and market-level barriers associated with using one-to-one and many-to-many HIE methods for sharing information may affect progress in interoperability. Examining the barriers to using multiple HIE methods and their impact on interoperability could offer implications for health information technology (IT) policy and inform health system leaders.
医院可能采用各种信息传输方式参与健康信息交换（HIE）计划。然而，即使采用了多种机制，他们也可能不会主动使用所有机制来发送内部信息。本研究分析了医院环境中发送数据的常用方法和常见的发送实践障碍。
我们的样本包括在 2019 年美国医院协会信息技术补充调查中报告其发送患者健康信息方法的 3015 家社区医院。使用稳健泊松回归模型分析了医院遇到的障碍与其使用信息发送方法之间的关系。
一旦采用了涉及中介机构（如健康信息服务提供商（HISP）、基于电子病历（EHR）供应商的网络和国家网络的多方对多方交换）的方法，就比医院更常使用一对一交换方法，如提供者门户和通过登录凭据直接访问 EHR。缺乏电子发送患者健康信息技术能力的医院不太可能使用任何一种方法（p<.01），而位于更集中市场的医院更有可能通过使用提供者门户、接口连接和国家网络向外部提供者发送信息（p<.01）。
医院采用不同的 HIE 方法发送内部信息给外部组织的情况与实际使用情况之间仍存在显著差距。结果表明，即使医院采用了 HIE 方法，他们也不一定会参与实际的信息共享，由于存在多种使用障碍，该方法可能仍未被使用。
与使用一对一和多对多 HIE 方法共享信息相关的医院和市场层面的障碍可能会影响互操作性的进展。检查使用多种 HIE 方法的障碍及其对互操作性的影响，可能为健康信息技术（IT）政策提供启示，并为卫生系统领导者提供信息。
