Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. B.3. Facet: Use and Workflow Related to Health Information Exchange

10/29/2013

Categories that are tied to the actual use of exchanged health information, including exchange through more conventional means (e.g., paper print out, fax, in person) are captured under this facet. This facet covers not only the "individual" user but also the "group" user discussed in many of the models that were used to develop the HIT organizational framework. Also included are the individual factors relevant to many of the care coordination models such as type of LTPAC/LTSS provider, clinical disciplines involved in the HIE intervention, "ownership," usability, motivation, workflow, perception of usefulness, adequate training, and comfort with an HIE intervention and related technology.

Capturing details around user attitudes, usability and workflow, ownership, and knowledge provides insights critical to understanding how HIE is used to support care coordination and its impact on care. This information can help to identify user-related barriers and facilitators.

TABLE B-4. Examples of Categories Associated with the Use and Workflow Facet

  Category     Characteristics     Examples of Sub-categories  
and Measures
  Important to Capture  
for LTPAC/LTSS HIE
HIE User
  • Type.
  • Clinical discipline.
  • Role.
  • Clinical discipline: RN, care coordinator, social worker, discharge planner, MD, interdisciplinary care teams, therapy, pharmacy, other clinicians, caregivers.
  • How different types of users interact with the HIE approach, intervention, tool.
  • Clinical providers & other types use of HIE to support care (e.g., care managers).
User Attitudes
  • Covers a wide range of concepts such as user satisfaction, perceived usefulness & usability, & user acceptance.
  • User satisfaction, perceived usefulness & usability, user acceptance, trust in information.
  • Value of information that is exchanged for care coordination.
Workflow
  • Workflow related to HIE.
  • How HIE support structures in place to coordinate care.
  • Whether workflow considerations & changes were reviewed & implemented.
  • How exchanged information is available workflow insertion points (e.g., at time of resident admission assessment).
  • Who has access to information (providers, team members, care planners, caregivers, regulators).
  • Insertion of HIE into workflow by mechanism, type of user/provider.
  • Sequencing: How HIE supports a task or decision that must await completion of another.
  • Hand-offs: Practitioners' depends on receiving critical information from another.
Ownership/ Buy-in
  • Captures level of user involvement & participation in HIE & related implementation process.
  • Culture of safety, support, & training for HIE use in care planning.
  • User views around value of an HIE to care delivery.
Knowledge
  • Includes concepts around adult learning, training, capability to use HIE.
  • Adult learning, knowledge, capability, comfort with computers & technology, training effectiveness, modality, staff turnover, & impact on staff with capability to use HIE.
  • User comfort & expertise with technology such as EHRs.
  • Capability of staff to use & support HIE.

 

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