Performance Improvement 2010. Advance Health Information Technology


Although electronic health records for newborns need to interoperate with newborn screening information systems, a HRSA-funded review at Johns Hopkins University indicated that the critical clinical care centers collecting newborn health screening information had minimal integration and interoperability with the health information systems of public health agencies responsible for administering the screening programs.  Newborn Screening programs include newborn bloodspot and hearing screening.  The screening, conducted at the birthing facility within three days of birth, represent the first information exchange between clinical care and public health authorities in the life of a child. (9218)

A qualitative study in South Carolina examined the benefits from using personal health records that elderly Medicare fee-for-service beneficiaries recognize.  There were varying definitions of personal health records, attributes and models being offered in the current market.  Additionally, there are limited standard measures for usability and utility and no guidelines for development.  Broad outreach and marketing strategies are needed to increase consumers' awareness about personal health record value and to improve their use before measuring and determining health effects on users.  Barriers impeding provider personal health record use include the potentially negative affect on office workflow, data inconsistencies, and the lack of reimbursement for provider participation.  A few technical standards are available or in development such as those by Health Level Seven and Integrating the Healthcare Enterprise (IHE).  The study also identified consumer functional preferences, including: pre-populated, downloadable data; simplified log-ins; strong technical support; streamlined and combined administrative and clinical data; direct on-line communication between patient and provider such as prescription refills or email contact; and alerts and tracking mechanisms for monitoring preventative or chronic conditions.  (9203)

The Office of the National Coordinator for Health Information Technology (ONC) funded a synthesis of field research that identified ways that state-level health information exchange organizations can advance interoperability.  Nearly all states have state-level health information exchange initiatives.  These public-private collaborations support interoperable health information exchange that serve to reach state-wide goals for quality and cost-effective healthcare.  Established state-level health information exchange organizations demonstrate that they can effectively engage state governments and provide a mechanism to forge new collaborations for data sharing across regions and among organizations that have traditionally used data for competitive purposes.  As a nationwide health information network is established, state-level initiatives are uniquely positioned to play ongoing roles in fostering state-wide collaboration, multi-stakeholder governance and multi-state coordination. (8593.1)

HHS developed methods to assess adoption of electronic health records by small-to-medium size physician practices which provide primary care to fee-for-service Medicare beneficiaries with selected chronic diseases.  These survey methods, once approved by OMB, can be used to assess practices' progress in implementing and use of electronic health records and related functionalities and to determine incentive payments for treatment group practices. (9204)

Research funded by ASPE reviewed literature on surveys intended to provide information to better understand barriers to adoption and use of electronic health records and other health information technology in nursing homes and home health agencies.  The lack of consistent definitions, terminology, item construction, sampling frames, and measurement criteria render it difficult to accurately gauge current health information technology adoption.  These same problems were observed for surveys of physician and hospital health information technology adoption.  The researchers found that almost all nursing homes and home health agencies use health information technology to support patient assessments and claims, and at least 20% of nursing homes and more than 30% of home health agencies use electronic health records, similar to the rates reported by hospitals and physicians.  Adding a parsimonious set of questions concerning the adoption, use, and barriers to the adoption and use of health information technology in nursing homes to the National Nursing Home Survey would produce nationally representative findings on this subject. (9316

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