Health Information Exchange in Post-Acute and Long-Term Care Case Study Findings: Final Report. B. Project Objectives

09/18/2007

The four goals of this project were to: (1) describe the current status of the use of HIT in state-of-the-art HDSs and how health information is or is not exchanged between "unaffiliated" PAC/LTC providers and other components of the health care delivery continuum (e.g., physician offices, laboratories, pharmacies, and hospitals) that use HIT; (2) identify the factors that support or deter the timely exchange of needed health information to and from unaffiliated PAC/LTC providers and other components of the health care delivery continuum that use HIT; (3) identify the policy levers that could be used to encourage information exchange by HDSs that use HIT with unaffiliated PAC/LTC providers; and (4) summarize and organize information learned and describe the next steps that could be pursued to extend electronic HIE (e-HIE) technologies into PAC/LTC.

All activities, which included a literature review, stakeholder interviews, site visits, and resultant case studies attempted to answer one or more of the following research questions:

  1. In select health care delivery systems:

    1. What HIT is being used to support the: (1) creation, storage, and exchange of summaries of physician office visits and hospital stays; and (2) computerized provider order entry (CPOE) including medication ordering, and laboratory results reporting?
    2. What hardware and software are used to support these functions and how do they support these functions?
    3. To what extent does HIT use nationally-recognized (e.g., CHI-endorsed) HIT vocabulary and messaging standards to create and exchange health information within the HDS?
    4. What is the health system architecture that supports the creation, storage, and exchange of these summaries, orders, and reports of results?
  2. What type of health information is needed for summary documents of hospital stays, physician office visits, medication orders, and laboratory tests?

  3. Within selected health care delivery networks, what clinical information is exchanged as part of the summaries of physician office visits and hospital stays, physician orders, and reports of test results?

  4. What health information is exchanged between health care providers and unaffiliated PAC/LTC settings and what are the mechanisms used to exchange information?

  5. What factors do PAC/LTC providers and representatives from the selected health care delivery systems identify as supporting or creating barriers to the timely exchange (in any form; i.e., electronic, fax, paper, etc.) of physician and hospital summaries, physician orders, and results reporting between HDSs and PAC/LTC providers?

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