Online Program

Enhancing care coordination through HIE with use of emergency department & inpatient notifications

Monday, November 4, 2013

Haley Sulser, Information Services, Louisiana Public Health Institute, New Orleans, LA
Kristin Lyman, JD, MHA, Health Systems Division, Louisiana Public Health Institute, New Orleans, LA
David Kulick, MPH, Crescent City Beacon Initiative, Louisiana Public Health Institute, New Orleans, LA
Liam Bouchier, Division of Information Services, Louisiana Public Health Institute, New Orleans, LA
Gaurav Nagrath, MBA, Louisiana Public Health Institute, New Orleans, LA
Anjum Khurshid, MBBS, PhD, Health Systems Development, Louisiana Public Health Institute, New Orleans, LA
Background Through the Office of the National Coordinator for Health Information Technology's Beacon Community Program, the Greater New Orleans area was afforded an opportunity to improve on the community's care coordination through health information exchange.

Objective The Greater New Orleans Health Information Exchange (GNOHIE) promotes a bidirectional capacity for sharing information among participating organizations. Participating providers include public and private hospitals and clinics. The increased communication of information among providers through the GNOHIE enhances and facilitates care coordination and chronic disease management efforts.

Methods Interventions implemented through use of the GNOHIE include emergency department and inpatient notifications (including clinical summaries) from hospitals to primary care practices. The retrospective and ongoing evaluation of this intervention is made possible using multiple methods. Sources of information include the GNOHIE, electronic health records (EHR) systems, site visits and individual interviews with key clinic and hospital staff.

Results Research remains ongoing, and preliminary findings will be presented. The GNOHIE indicators include: 1) The number of transactions going to the primary care provider/medical home from the emergency department/inpatient hospital setting, 2) The extent to which the notifications and clinical summaries transmitted from the GNOHIE to the primary care practice EHRs are used by primary care providers to proactively manage the care of their patients, and 3) The frequency with which patients visit facilities outside of the medical home.

Discussions There has been a great improvement in the coordination of care in the Greater New Orleans area through the GNOHIE and other initiatives in which the community works together to provide coordinated care. Work will continue for the foreseeable future, thus it may be hard to parse out the effectiveness of a single intervention over time, but the results of this research will show marked improvements in achieving the goal of enhanced care coordination for the community.

Learning Areas:

Administration, management, leadership
Communication and informatics

Learning Objectives:
identify differences between unidirectional and bidirectional health information exchange and how this affects the ED/Inpatient Notification intervention. analyze the effects of ED/Inpatient Notification on care coordination and chronic disease management in the primary care setting. describe the successes and challenges associated with the implementation of a bidirectional health information exchange interventions.

Keyword(s): Emergency Department/Room, Information System Integration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the project manager for health information efforts in Louisiana, including the Greater New Orleans Health Information Exchange. Through this position, I gained expertise on implementation of interventions reliant on health information technology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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