A new study from the US Department of Veterans Affairs, Regenstrief Institute, IUPUI and Icahn School of Medicine on Mount Sinai reports that primary care physicians recognize the need for better coordination and welcome notifications of ‘Health Information Exchange (HIE) events as a means of improving the flow of information to enable better patient care.
Individuals often receive medical care from more than one health system. Coordinating care between providers, for example after discharge from an emergency department or hospital in one system, with the patient’s primary care physician in another, is difficult and often does not occur. This siled approach to medical care with incomplete sharing of clinical information can have a negative effect on health outcomes.
“Although our study focused on patients whose primary care was provided in the VA system, this is a problem faced by patients and their providers in many, if not most, healthcare systems. in the United States, ”lead study author Brian Dixon, PhD, MPA, Regenstrief and Indiana University Richard M. Fairbanks School of Public Health at IUPUI director of public health informatics.
Dr Dixon and colleagues have reported that VA system primary care physicians are generally not notified when their patients are seen in a non-VA emergency department or hospitalized in a non-VA facility, so physicians are not. unaware of the need for follow-up and often have to wait months to learn of the event from a patient himself – months during which the patient did not receive care from the physician responsible for monitoring his condition general health.
The majority of Americans rely on their primary care physician to coordinate specialist physician care and hospitalizations. They expect their doctor to know about their care, but most of the time that is not the case. Our study is unique in that we investigated the perspectives of primary care teams on the use of an electronic database – the exchange of health information – to enable automatic notifications – for example, a doctor’s patient primary care was hospitalized for a heart attack – to remedy this problem and has found a positive reception. “
Brian Dixon, PhD, MPA, lead study author, Regenstrief Institute
Primary care team members interviewed by study authors considered e-alerts (for example, notification that a patient was seen in the emergency department for chest pain and discharged home when they were was determined not to be a cardiac event) as both necessary and effective in supporting timely follow-up care, especially for older people at higher risk of such medical events.
The study, “Perceptions of event notification after discharge to better geriatric care: qualitative interviews of care team members from a 2-site cluster randomized trial” appears online ahead of print in Journal of the American Medical Informatics Association (JAMIA).
The authors, in addition to Dr. Dixon, are Emily Franzosa, Morgan Traylor, Kimberly Judon, Vivian Guerrero Aquino, Ashley L. Schwartzkopf, and Kenneth S. Boockvar, all from the VA. Dr Boockvar is also part of the Icahn Faculty of Medicine at Mount Sinai.
Now that this qualitative study has demonstrated the perceived benefits and acceptability of electronic event reporting by primary care physicians and their teams, Dr Dixon and colleagues are working on a quantitative analysis, also measuring the real impact of these events. follow-up care notifications. such as preventing repeat emergency department visits and rehospitalizations.