An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities

In this quantitative study, we examined how three critical Health IT capabilities (interoperability, electronic health information exchange, and medication reconciliation) influence one another, and what the resulting policy implications are, in the midst of current challenges, such as stagnation in hospitals' adoption of data integration functionalities and reduction in the number of operational health information exchanges. We found that a significant, positive, and cyclic relationship exists between the three Health IT capabilities, in that decreases in the hospitals’ adoption of one would lead to decreases in the adoption of the others. This finding suggests that, without improving adoption of interoperability and health information exchange capabilities, capability for high quality medication reconciliation may be impeded. Policy interventions focused on improving one or more of these capabilities may have ancillary benefits

Figure 2-Final confirmatory factor & Path analyses

<p>This figure is from our article titled, <i><a href="http://journals.lww.com/md-journal/Abstract/2017/10130/An_observational_study_of_the_relationship_between.26.aspx">An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities</a></i>, pushed in the journal <i>Medicine</i>. It displays the results of our partial least squares-structural equation modeling analysis, supporting our hypotheses that the relationships between hospitals' adoption of electronic health information exchange, interoperability, and medication reconciliation capabilities are significant, positive, and cyclic, in that if any one of them decreases, then the others will decrease as well as a result. This finding suggests that, without improving adoption of interoperability and health information exchange capabilities, capability for high quality medication reconciliation may be impeded. Policy implications of this finding and others are also discussed in the <a href="http://journals.lww.com/md-journal/Abstract/2017/10130/An_observational_study_of_the_relationship_between.26.aspx">article</a> published in the journal <i>Medicine</i>.</p

Improving quality of preventive care at a student-run free clinic.

Student-run clinics increasingly serve as primary care providers for patients of lower socioeconomic status, but studies show that quality of care at student-run clinics has room for improvement.To examine change in provision of preventive services in a student-run free clinic after implementation of a student-led QI intervention involving prompting.Review of patient charts pre- and post-intervention, examining adherence to screening guidelines for diabetes, dyslipidemia, HIV, and cervical cancer.Adherence to guidelines among eligible patients increased after intervention in 3 of 4 services examined. Receipt of HIV testing increased from 33% (80/240) to 48% (74/154; p = 0.004), fasting lipid panel increased from 53% (46/86) to 72% (38/53; p = 0.033), and fasting blood glucose increased from 59% (27/46) to 82% (18/22; p = 0.059).This student-run free clinic implemented a student-led QI intervention that increased provision of prevention. Such a model for QI could extend to other student-run clinics nationally