Health Information Exchange in Post-Acute and Long-Term Care Case Study Findings: Final Report. A. Overview: What is Unique about this Research

09/18/2007

The Federal Government and many state administrations see the broad implementation of HIT as an important lever by which to improve health care quality and safety, and reduce costs. Implementing HIT will support the exchange of data as patients move between health care settings, and such exchange will measurably decrease errors, enable more timely and productive clinical decisions, and allow for a more comprehensive patient-centric longitudinal electronic record (Coleman, May, Bennett, Dorr, & Harvell, 2007). To this end, hospitals and ambulatory settings are implementing EHRs that are increasingly compliant with national standards. However, adoption of HIT solutions in NHs and HHAs has lagged behind hospitals and ambulatory care settings.

This project set out to identify what information is exchanged between hospitals, physician offices, and ancillary health providers (such as laboratories and pharmacies), and NHs and HHAs. The project also asked how and whether HIT is being used to facilitate HIE with and between NHs and HHA providers. These questions were posed to several early adopters that have implemented HIT to support the exchange of health information as patients change care settings. In particular, this effort focused on whether there were any differences in the types, content, or format of data that were shared with affiliated as opposed to unaffiliated care settings. Further, the project asked whether HIE strategies employed by leading HDSs could be replicated elsewhere and what lessons were learned as implementers developed their information technology solution(s). Specifically, the project team sought to understand what worked and what did not work as expected at the sites visited. More generally, the team wanted to identify what facilitated and impeded both electronic and non-electronic HIE.

Ultimately, the answers to these key questions can provide information to health care leaders and policy makers on: (1) the patient health information that needs to be exchanged with NHs and HHAs; and (2) the use of HIT to support HIE. This knowledge may help to inform a national strategy to promote more widespread interoperability towards the ultimate objective of improving the quality of health care in this country.

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