USAGE PATTERNS OF HEALTH INFORMATION EXCHANGE: ANTECEDENTS AND CONSEQUENCES

Health information exchange (HIE) systems integrate patient-level data that originates in several health information systems (HISs). As these systems bridge information gaps, they are expected to improve the caregiving process in terms of resource utilization and quality of care. Nevertheless, effective use of the system is a hurdle in realizing these benefits fully. Understanding actual individual use of the system is therefore of great importance. Several studies described factors that result in the use of the system, yet seldom examined their affect on characteristics of use. Furthermore, few studies empirically evaluated the association between the characteristics of actual individual use and decisions made during treatment. In this study, we intend to identify the antecedents of pattern of system use, namely patient-related, user-related, and environmental factors. The pattern of use is described by several variables. We then explore the link of the pattern of use and potential antecedents to clinical decisions, specifically the unit to which patients were admitted and the number of ancillary tests ordered. Our hypotheses are tested using clinical data and HIE log files of an emergency department (ED) in a large Israeli hospital

The Impact of Introducing an Electronic Medical Record on the Use of Health Information Exchange in the Emergency Department

Whereas physicians access multiple systems in search of information about patients, there is little research on how their use of one system is affected by the introduction of another system. This research-in-progress examines how the use of a health information exchange system (HIE) by physicians treating critically-ill patients in the emergency department is affected by the introduction of an electronic medical record (EMR). We test how the number of screens viewed (volume) and the time devoted to each screen (duration) are affected by variables characterizing the patient, physician, situation, and available information, and how these effects are moderated by EMR availability. Our preliminary results show that following EMR implementation, physicians access the HIE less frequently and view the same number of screens, yet they devote more time to each screen. Moderation effects suggest that the context of use is crucial to understanding system complementarity and substitution in health information ecosystems