6 research outputs found
Survey of HIE Leaders: Assessment of HIE Research Participation and Perceptions
Introduction: Health information exchanges (HIEs) allow for healthcare providers to effectively and securely access patient information from various healthcare networks. Some HIEs have acknowledged the important role they can play in research, however, this is not standard practice despite recognition that availability of research and outcomes data is a main limitation to evidence-based practice.
Methods: We created an electronic survey in collaboration with Health Share Exchange (an HIE in Philadelphia) with the aim of assessing HIE leader perceptions regarding the importance of and barriers to participation in research. The survey was disseminated via a Strategic Health Information Exchange Collaborative (the national association for HIEs) listserv that encompasses 70 HIEs in 49 states.
Results: Leaders of HIEs from Philadelphia, Georgia, Colorado, and Michigan responded to our survey (n = 4). All HIEs represented in this survey either participate in research currently or indicated an interest in participating in research, and all noted that they face barriers to participating in research, including (but not limited to) legal concerns, logistical barriers to sharing data, and reluctance from clients to allow sharing of data for research purposes. HIEs that indicated the need for assistance with research participation noted that legal and policy-related support is needed to improve research participation.
Conclusions: The HIEs that participated in our survey indicated that although they are interested in participating in research, there are legal and logistical barriers that prevent them from doing so. Future work should survey additional HIEs across the U.S. and discuss solutions to the barriers acknowledged in this work
Recurrent violent injury: magnitude, risk factors, and opportunities for intervention from a statewide analysis.
INTRODUCTION: Although preventing recurrent violent injury is an important component of a public health approach to interpersonal violence and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established.
METHODS: We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following up patients injured in 2010 for recurrence through 2012. We assessed risk factors for recurrence with multivariable logistic regression and estimated time to recurrence with the Kaplan-Meier method. We tabulated hospital charges and costs for index and recurrent visits.
RESULTS: Of 53 908 patients presenting for violent injury in 2010, 11.1% had a recurrent violent injury during the study period. Trauma centers treated 31.8%, including 55.9% of severe injuries. Among recurrers, 58.9% went to a different hospital for their second injury. Low income, homelessness, Medicaid or uninsurance, and black race were associated with increased odds of recurrence. Patients with visits for mental and behavioral health and unintentional injury also had increased odds of recurrence. Index injuries accounted for 25.3 million.
CONCLUSIONS: Recurrent violent injury is a common and costly phenomenon, and effective violence prevention programs are needed. Prevention must include the nontrauma centers where many patients seek care
Examining the Role of Diagnosis in the Emergency Department Experience
Study Objective:
To explore the social, functional, and emotional needs that patients want addressed when seeking a diagnosis at their ED visit.https://jdc.jefferson.edu/cwicposters/1037/thumbnail.jp
Hospital Community Benefit: What is it, why is it important, and how could it be more effective?
Patient Perception of Telehealth Primary Care Video Visits
Introduction Telehealth (TH) is an innovative model of care delivery with potential to provide more patient-centered healthcare, allowing patients to receive care when and where is most convenient. To date, little is known about patient perceptions of receiving care with the use of TH video visits.https://jdc.jefferson.edu/medposters/1002/thumbnail.jp
Understanding Patient Uncertainty as a Driver of Emergency Department Utilization: A Concept Mapping Approach
Background and Purpose Most previous research regarding factors associated with increased risk of emergency department (ED) use has been done via retrospective review of medical records rather than obtaining patients’ perspectives. Recent research identified patient uncertainty related to symptoms as a primary motivator for seeking ED care, and ongoing uncertainty at the time of ED discharge as an unmet need (Rising et al. 2015; Rising, Hudgins, Reigle, Hollander, & Carr 2016). While providers have limited ability to influence many factors identified by retrospective medical record review (e.g. financial concerns), patient uncertainty can be addressed by providers directly. To do so we must first define domains of uncertainty that patients experience in order to inform targeted interventions to address patient uncertainty. The objective of this research was to engage patients through group concept mapping (GCM) to conceptualize the domains of uncertainty that contribute to decisions to seek care in the ED.https://jdc.jefferson.edu/emposters/1000/thumbnail.jp