Barriers and facilitators to exchanging health information: a systematic review |
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| Institution: | 1. Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Locked Bag No. 10, Wallsend, NSW 2287, Australia;2. School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;3. Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;4. Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia;5. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, Canada;6. School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada;7. School of Psychology, University of Ottawa, Ottawa, Ontario, Canada;8. University Library, Academic Division, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;1. Michigan State University, College of Human Medicine, Department of Family Medicine, East Lansing, MI 48824 USA;2. Michigan State University, College of Human Medicine, Institute for Health Policy, East Lansing, Michigan 48824 USA;3. Sparrow Home Care, Sparrow Health System, Lansing, Michigan 48912 USA;4. Michigan State University, College of Human Medicine, Department of Family Medicine, Grand Rapids, Michigan 49503 USA |
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| Abstract: | ObjectivesWe conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE).MethodsWe searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed.ResultsTen cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use.DiscussionIncomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied.ConclusionsWe identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation. |
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| Keywords: | Health information exchange Users perceptions Barriers Attitude to computers |
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