Heath Information Exchange (HIE) and Emergency Preparedness (EP) in a Georgia Public Health District– A Case Study
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Abstract
Background: Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of the American Recovery and Reinvestment Act of 2009, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONCHIT) have jointly proposed the adoption and implementation of Electronic Health Records with Meaningful Use. These recent developments in health information technology require health districts/ local health departments to use EHRs for health information exchange.
Objective: The primary objective of this case study was to assess the present situation on health information exchange in emergency preparedness, its reporting and getting the response. The aim was to observe the status of Health District’s IT infrastructure, EHR installation, security, and linkage with the State Health Department, Eligible Practitioners (EPs), Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) in relation to the Meaningful Use of EHRs.
Methods: One health district in Georgia volunteered to participate in this case study. The primary data was obtained for the case study from semi-structured phone interviews. During face to face interviews, qualitative information was collected from health professionals, including Health Director, Emergency Preparedness Director, and IT Chief. The case study guiding questions were pretested before conducting the in-depth interviews. The key informant interviews were recorded using a digital recorder. These recordings were transcribed and contents were reviewed to reduce overlap and redundancy of coded data. Collapsed codes were arranged into following themes: technical readiness and infrastructure; process readiness and required reporting; and leadership, policy and governance. The qualitative software N-Vivo was used to code the data.
Results: The Health District is facing challenges to meet the requirements of the EHR-Meaningful Use and health information exchange. Fear of change and obtaining monitory support from the state and federal agencies are the biggest challenges; whereas, barriers to implementation are time-consuming transfers from paper-based medical records to electronic medical records, running different databases and different versions of present electronic systems, acquiring financial ability to upgrade the systems, training of the users, and obtaining technical support from State Health Department.
Conclusion: At the conclusion of this study, readiness for the Stage-2 MU public health measures on the receiving end is slow. To reach the goal of health information exchange, adoption of connected, interoperable, and secure electronic health records (EHRs) is foundational. Interoperable systems must be capable of securely and confidentially delivering complete and accurate data to the State Health Department, hospital emergency physicians and patients when and where it is needed.
Objective: The primary objective of this case study was to assess the present situation on health information exchange in emergency preparedness, its reporting and getting the response. The aim was to observe the status of Health District’s IT infrastructure, EHR installation, security, and linkage with the State Health Department, Eligible Practitioners (EPs), Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) in relation to the Meaningful Use of EHRs.
Methods: One health district in Georgia volunteered to participate in this case study. The primary data was obtained for the case study from semi-structured phone interviews. During face to face interviews, qualitative information was collected from health professionals, including Health Director, Emergency Preparedness Director, and IT Chief. The case study guiding questions were pretested before conducting the in-depth interviews. The key informant interviews were recorded using a digital recorder. These recordings were transcribed and contents were reviewed to reduce overlap and redundancy of coded data. Collapsed codes were arranged into following themes: technical readiness and infrastructure; process readiness and required reporting; and leadership, policy and governance. The qualitative software N-Vivo was used to code the data.
Results: The Health District is facing challenges to meet the requirements of the EHR-Meaningful Use and health information exchange. Fear of change and obtaining monitory support from the state and federal agencies are the biggest challenges; whereas, barriers to implementation are time-consuming transfers from paper-based medical records to electronic medical records, running different databases and different versions of present electronic systems, acquiring financial ability to upgrade the systems, training of the users, and obtaining technical support from State Health Department.
Conclusion: At the conclusion of this study, readiness for the Stage-2 MU public health measures on the receiving end is slow. To reach the goal of health information exchange, adoption of connected, interoperable, and secure electronic health records (EHRs) is foundational. Interoperable systems must be capable of securely and confidentially delivering complete and accurate data to the State Health Department, hospital emergency physicians and patients when and where it is needed.
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