Topics

Evaluation of a Regional Electronic Health Information Exchange's Clinical Health Record

2014-08-27 03:19:17 | BioPortfolio

Summary

The Shared Health CHR™ (Clinical Health Record) offers point-of-care clinical reporting and decision support based primarily on patient claims data aggregated across various health care settings, and is one example of the types of health information data exchange efforts being implemented across the country. This study will evaluate how the CHR is used and its clinical and financial impact to better understand the CHR's value, and to identify opportunities to enhance the system to support patient care and practice efficiency. In addition, the results from this study will help to inform the national debate about the effectiveness of these types of tools to maximize patient quality of care, patient safety, and practice efficiency.

Description

Missing information at the point of care is frustrating for both physicians and patients and can lead to unnecessary tests or suboptimal or even inappropriate and potentially harmful treatment. In addition to the risks of poorer quality of care, this fragmentation of incomplete or unavailable clinical data may result in increased costs to the healthcare system. Patient health records, when electronically shared across a spectrum of patient care settings, offer the possibility of improving healthcare outcomes, including patient safety and quality of care, and increasing efficiency, as well as cost-effectiveness.

This overall study will consist of two analyses. First, we will conduct a before-and-after, or pre-post study. The clinical practices consenting to participate will serve as their own controls during the baseline period. During the baseline period for which data will be retrospectively captured, physicians will have been conducting "business as usual" without the use of the CHR. The intervention will consist of participants accessing CHR to assist with medical decisions and patient care. Secondly, we will conduct a concurrent matched cohort comparison of patients within practices. We will compare outcomes and gaps in care for patients whose care is associated with very frequent CHR use and less frequent CHR use to matched control patients whose care is not associated with CHR use.

Safety, quality, and cost outcomes will be compared using the two described approaches. First, we will compare outcomes and gaps in care for the intervention patients whose care involved active CHR use in the intervention period to the care these same patients received during the baseline periods (pre/post analyses). Secondly, we will compare outcomes and gaps in care of the intervention active patients, both super-active and less active, to the matched control patients whose care during the study did not involve any CHR use during the intervention period (matched cohort analysis).

In order to study the relationship of CHR use to clinical, financial, and office efficiency outcomes within the study's timeline, we will limit our study to pre-existing patients and new patients who have had at least one encounter during the study period. Hospital admission data will also be analyzed as part of the cost and outcomes analysis.

We plan to study the effects of CHR on several conditions among the AHRQ's Ambulatory Care Sensitive (ACS) Conditions. We will study conditions that are common, high-risk, and resource dependent where clinical management may be improved with access to a CHR including chronic obstructive pulmonary disease/asthma, congestive heart failure, angina/coronary artery disease, and diabetes mellitus. In addition, other conditions determined to be of value in evaluating the impact of the CHR may be added, or may replace some of the existing conditions. These conditions will be chosen based on our early work in the study once we learn more about the number of eligible patients and the numbers of clinical interactions. The new conditions, yet to be determined, may also include non-chronic, or acute, diagnoses.

Study Design

N/A

Conditions

Impact of Health Information Exchange on Patient Care

Status

Active, not recruiting

Source

Brigham and Women's Hospital

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:19:17-0400

Clinical Trials [5535 Associated Clinical Trials listed on BioPortfolio]

A Study of the Effect of Patient Education (Talking Health Together) in Improving Doctor-patient Communication

This study is being carried out to see if patients make the lifestyle changes or take their medication as instructed by their doctor during their visit as a result of the T.H.T. patient-ed...

Regional Data Exchange to Improve Care for Veterans After Non-VA Hospitalization

Among older VA patients who have Medicare coverage, 43% use both VA and non-VA (Medicare-covered) services. VA and non-VA providers are often uninformed about encounters, treatments and te...

Assessing the Impact of Health Information Exchange (HIE) on Healthcare Utilization

The purpose of this study is to assess usage of the virtual health record (VHR), and determine the effects of this technology on healthcare utilization.

Effects of a Personalized Web-Based Antenatal Care Planner

Many women are turning to the Internet to meet their health information needs, but the large amount of information available, as well as the unknown reliability and applicability of inform...

The Impact of a Dermatology Information Source on Skin Problem Outcomes in Primary Care

Health care providers use a variety of computerized medical information sources to reduce knowledge gaps and support patient care decisions. Few studies have evaluated the impact of medica...

PubMed Articles [38922 Associated PubMed Articles listed on BioPortfolio]

Impact of a Prescription Drug Monitoring Program on Health Information Exchange Utilization, Prescribing Behaviors, and Care Coordination in an Emergency Department.

Timely access to patient data is critical in patient care. The utilization of health information exchange and prescription drug monitoring programs can make pertinent data readily accessible for emerg...

The associations between query-based and directed health information exchange with potentially avoidable use of health care services.

To quantify the impact of two approaches (directed and query-based) to health information exchange (HIE) on potentially avoidable use of health care services.

Status of health information exchange: a comparison of six countries.

Health information exchange (HIE) is frequently cited as an important objective of health information technology investment because of its potential to improve quality, reduce cost, and increase patie...

Potential impact of data source and interoperability messaging on health information technology (HIT) users: a study series from the United States Department of Veterans Affairs.

The promise of Health Information Exchange (HIE) systems rests in their potential to provide clinicians and administrative staff rapid access to relevant patient data to support judgement and decision...

Prediction of emergency department revisits using area-level social determinants of health measures and health information exchange information.

Interoperable health information technologies, like electronic health records (EHR) and health information exchange (HIE), provide greater access to patient information from across multiple organizati...

Medical and Biotech [MESH] Definitions

Organizational framework for the dissemination of electronic healthcare information or clinical data, across health-related institutions and systems. Its overall purpose is to enhance PATIENT CARE.

The purpose of this 1990 federal act is to assure that individuals receiving health care services will be given an opportunity to participate in and direct health care decisions affecting themselves. Under this act, hospitals, health care agencies, and health maintenance organizations are responsible for developing patient information for distribution. The information must include patients' rights, advance directives, living wills, ethics committees' consultation and education functions, limited medical treatment (support/comfort care only), mental health treatment, resuscitation, restraints, surrogate decision making and transfer of care. (from JCAHO, Lexicon, 1994)

Purchasers are provided information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. The focus is on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers. (from http://www.ahrq.gov/qual/meyerrpt.htm accessed 11/25/2011)

Automatic and seamless exchange or cross-talk of HEALTH INFORMATION across HEALTH INFORMATION SYSTEMS.

Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.

More From BioPortfolio on "Evaluation of a Regional Electronic Health Information Exchange's Clinical Health Record"

Quick Search

Relevant Topics

Nutrition
Within medicine, nutrition (the study of food and the effect of its components on the body) has many different roles. Appropriate nutrition can help prevent certain diseases, or treat others. In critically ill patients, artificial feeding by tubes need t...

Public Health
Alternative Medicine Cleft Palate Complementary & Alternative Medicine Congenital Diseases Dentistry Ear Nose & Throat Food Safety Geriatrics Healthcare Hearing Medical Devices MRSA Muscular Dyst...


Searches Linking to this Trial