According to SearchHealthIT, health information exchange is "the transmission of healthcare-related data among facilities, health information organizations (HIO) and government agencies..." Health information exchanges have been suggested as a tool to improve the delivery of care, especially in emergency departments and other acute care settings. However, there has been little evidence that proves they create actionable knowledge.
One study that indicates HIEs do produce actionable knowledge was presented at the Society of General Internal Medicine Annual Conference earlier this year. Dr. Lisa Mabry and colleagues presented a poster entitled "Does Health Information Exchange Use Improve Adherence With Evidence-Based Guidelines for Neuroimaging in the Emergency Evaluation of Headache?" Their study investigated whether ED staff use of the MidSouth e-Heatlh Alliance HIE, a health information exchange in the greater Memphis area, reduced the use of neuroimaging in patients presenting with repeat episodes of headache. Their results showed that although the HIE was only used in 21.8% of encounters, when it was used, it was associated with a 76% decreased odds of neuroimaging. Additionally, adherence to evidence-based guidelines was improved.
These results indicate that, at least with regard to headache, the HIE does provide the user with actionable knowledge. If the HIE was used more frequently, unnecessary cost, testing, and radiation exposure could be avoided.
As creation and utilization of health information exchanges expands, it is important to design them in a fashion that assists users in reaching the threshold for actionable knowledge. Focusing on overcoming technical challenges to allow for the transmission of data within HIEs rather than insuring their ability to communicate actionable knowledge will limit the effectiveness and relevance of this technology.
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