1,352,882 research outputs found
Arizona Health Information Exchange
abstract: Arizona strives to be the national role model for the secure, interoperable health information exchange to facilitate safe, secure, high quality and cost effective health care. The purpose of the Health Information Exchange in Arizona is to improve the quality, safety and efficiency of wellness in the Arizona population by securely connecting patients and health care providers so that relevant and understandable information is available anytime, anywhere
Applications of health information exchange information to public health practice
Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health
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Impact of health information exchange adoption on referral patterns
Efforts to promote Health Information Exchanges (HIE) on a nationwide scale are beset with major challenges and one of them is its meaningful use for both physicians and patients. Referrals potentially provide a context for the meaningful use of HIE and we are yet to understand how HIEs affect referrals. This research studies the impact of HIE on referral patterns. We establish that participation in an HIE network increases the referrals sent to and received from other HIE participants. We investigate this relationship using both econometric and network-analytic methods. While the econometric analysis focuses on the underlying associations between HIE adoption and referral patterns, the network analysis addresses the transformation process by which HIE adoption and referrals co-evolve over time. This study has significant implications for healthcare policy-making, development of innovative HIE business models, and management of healthcare organizations
Information technologies that facilitate care coordination: provider and patient perspectives
Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration
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Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)
[Excerpt] A health insurance exchange is a structured marketplace for the sale and purchase of health insurance. “Customers” can include individuals and businesses. The insurance companies (“issuers”) that choose to sell their products through an exchange may be required to comply with consumer protections, such as offering insurance to every qualified applicant. Exchanges, however, are not issuers; rather, exchanges contract with issuers who will make insurance products available for purchase through exchanges. Essentially, exchanges are designed to bring together buyers and sellers of insurance, with the goal of increasing access to coverage.
This rather broad definition allows for a great deal of latitude, and therefore variance, in the number and scope of responsibilities covered in a particular exchange. For example, the role of an exchange may be more or less administrative: facilitating the sale and purchase of health insurance. An administrative-only exchange may function similar to websites that allow individuals to find airline travel options and purchase tickets (e.g., Kayak). Such an approach does not necessarily change or establish standards for the products being sold (whether they are health plans or airline tickets), or limit the types of buyers and sellers participating in the exchange, beyond what already exists in the private market. An example of a minimalist health insurance exchange is the Utah Health Exchange. Essentially, Utah’s exchange is an Internet portal that is “designed to connect consumers to the information they need to make informed health care choices, and in the case of health insurance, to execute that choice electronically.”
At the other end of the spectrum, an exchange may have multiple functions beyond the role of insurance marketplace. For instance, an exchange may be responsible for implementing regulatory standards, such as requiring standardization of all products offered through it or imposing requirements on exchange participants. An exchange may be responsible for determining eligibility for exchange plans and government-provided subsidies. An example of a more regulatory-oriented exchange is the Health Connector (“Connector”) in Massachusetts. Similar to Utah’s exchange, the Connector provides an online tool to allow consumers and others to find commercial health insurance options available to them. In addition, the Connector also manages a publicly subsidized coverage program for low-income state residents, and offers certificates to exempt individuals from the state’s individual mandate, among other duties.
An exchange may occupy a physical location and/or be virtual (i.e., performing its functions on the Internet). It may be governed by a public agency, a private entity, or a hybrid organization. The insurance options offered through an exchange may also vary across insurance markets and plan types. Nonetheless, while the authority and responsibilities of an exchange may vary, its fundamental purpose is to provide a venue where insurance companies may sell their insurance products and purchasers can compare and choose from multiple options available to them. Thus an exchange allows for “one-stop shopping” with respect to health insurance.
The exchange concept was included in the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended), as a means to increase access to health insurance. While ACA places many restrictions on the design and function of exchanges, the law also leaves many operational decisions to the states. Such flexibility will likely lead to variation in exchange models across the states. For example, a state may decide to operate an exchange by itself, establish an exchange in partnership with the federal government, or leave this work entirely to the federal government. States had to declare whether they will have a state exchange by December 14, 2012. By February 15, 2013, states must declare whether they will operate an exchange in partnership with the federal government. The initial open enrollment period for all exchanges will begin on October 1, 2013, and all exchanges are to be operational and offering coverage on January 1, 2014.
This report looks at the requirements for exchanges established in ACA and provides information on the requirements and choices available to states for the establishment, functions, financial responsibilities, and coverage of the ACA exchanges. It also includes a brief discussion of the interactions between exchanges and other provisions in the law
Evaluating public health uses of health information exchange
AbstractHealth information exchange (HIE) initiatives are in various stages of development across the United States. They aim to bring previously unavailable clinical data from patients’ disparate health records, which may be spread over multiple provider and payer networks, to the point of care where clinicians and their patients need it most. The implications of these initiatives on public health are numerous. This article provides general evaluation methods for measuring the impact of HIE on public health in six use cases: (1) mandated reporting of laboratory diagnoses, (2) mandated reporting of physician-based diagnoses, (3) public health investigation, (4) disease-based non-reportable laboratory data, (5) antibiotic-resistant organism surveillance, and (6) population-level quality monitoring
Technology adoption in health care: International barriers and opportunities to telemedicine
Although telemedicine and telehealth are seen as discrete entities by some authors, both The Cochrane Library (2010) and the WHO (2009) acknowledge that definitions overlap. The broad and encompassing definition underpinning the WHO (2009) report states that telemedicine is:
The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communitie
Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.
BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested
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