Abstract

To examine whether integration of Health Information Exchange (HIE) services into office workflow would have an impact on ED visits and unplanned 30-day readmission amongst the patients who were treated at the medical practice. We designed and implemented a training program at a medical practice in Western New York over a period of three months between November 2016 and January 2017. During the program, a group of health IT professionals and clinical specialists trained the staff on how to appropriately use and efficiently integrate the HIE services in their workflow. We measured the effectiveness of the program using both qualitative and quantitative methods. We employed an Interrupted Time Series (ITS) analysis to examine the effectiveness of the program on reducing the number of patients who experience an ED visit or an unplanned hospital readmission within 30 days of initial discharge. After the implementation of the training program, the rate of unplanned hospital readmissions reduced by 2.7 patients per 1000 members per month and the rate of ED visits reduced by 6.3 patients per 1000 members per month. The results indicate that educating medical practices on how to efficiently utilize the HIE services, and especially the notification systems will significantly reduce the rate of ED utilization and unplanned 30-day hospital readmissions amongst the patients of medical practices.

中文翻译：

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评估将健康信息交换服务集成到医疗业务流程中的好处

摘要

为了检查将健康信息交换（HIE）服务集成到办公室工作流程中是否会对急诊就诊以及计划在医疗机构接受治疗的患者中30天意外入院产生影响。我们在2016年11月至2017年1月的三个月中，在纽约西部的一家医学诊所设计并实施了一项培训计划。在该计划期间，一群健康的IT专业人员和临床专家对员工进行了如何正确使用和进行培训的培训。将HIE服务有效地集成到其工作流程中。我们使用定性和定量方法评估了该计划的有效性。我们采用了中断时间序列（ITS）分析来检查该计划在减少初次出院30天内经历急诊就诊或计划外住院的患者数量方面的有效性。实施培训计划后，计划外的住院率降低了每千名成员每月2.7名患者，急诊就诊率降低了每千名成员每月6.3名患者。结果表明，就如何有效利用HIE服务（尤其是通知系统）进行医疗实践教育将显着降低医疗实践患者中ED利用率和计划外30天医院再入院率。每千名成员每月减少2.7例计划外住院患者的入院率，每千名成员每月进行急诊就诊的比例减少6.3名患者。结果表明，就如何有效利用HIE服务（尤其是通知系统）进行医疗实践教育将显着降低医疗实践患者中ED利用率和计划外30天医院再入院率。每千名成员每月减少2.7例计划外住院患者的入院率，每千名成员每月进行急诊就诊的比例减少6.3名患者。结果表明，就如何有效利用HIE服务（尤其是通知系统）进行医疗实践教育将显着降低医疗实践患者中ED利用率和计划外30天医院再入院率。