Abstract
BackgroundThe need for information exchange and integrated care has stimulated the development of interoperability solutions that bring together patient data across the health and care system to enable effective information sharing. Health Information Exchange (HIE) solutions have been shown to be effective in supporting patient care, however, user adoption often varies among users and care settings. This service evaluation aimed to measure user acceptance of HIE and explore barriers and facilitators to its wider uptake.MethodsA mixed-method study design was used. A questionnaire was developed using the Unified Theory of Acceptance and Use of Technology and administered to HIE users to assess technology acceptance. Pearson Chi2 tests were used to examine differences in acceptance between user groups and care settings. Web-based, semi-structured interviews were conducted drawing on the Normalisation Process Theory to explore barriers and facilitators to adoption. Interview data were analysed thematically using the Framework Approach.ResultsA total of 105 HIE users completed the survey and another 12 participated in the interviews. Significant differences were found in HIE acceptance between users groups and care settings, with high adopters demonstrating higher acceptance and social care users showing lower acceptance. Participants identified several drivers to adoption, including increased information accessibility, better care coordination, informed decision-making, improved patient care, reduced duplication of procedures, and time and cost savings. However, they also highlighted a number of barriers, such as lack of awareness about the solution and its value, suboptimal communication strategies, inadequate training and lack of resources for knowledge dissemination, absence of champions to support the implementation, lack of end-user involvement in the implementation and evaluation of HIE, unclear accountability and responsibility for the overall success of the programme, and patient confidentiality concerns.ConclusionsWorking to better engage stakeholders, considering the needs of users from different care settings, providing users with training resources and support to increase their knowledge and confidence in using the system, developing implementation strategies to seek user feedback and monitor performance, and using communication strategies to increase awareness of the product and its value, can help improve uptake and adoption of HIE.
Highlights
The need for information exchange and integrated care has stimulated the development of interoperability solutions that bring together patient data across the health and care system to enable effective information sharing
This necessitates the need for health and care information sharing and the availability of standards for secure data exchange across multiple Electronic Health Records (EHR) systems to develop new solutions that bring together health and social care information from siloed sources to support person-centred care
Health Information Exchange (HIE) solutions have been shown to provide a variety of benefits to health care systems, such as minimising gaps in patient histories, avoiding unnecessary duplication of procedures and investigations, reducing hospital admissions, referrals, and costs, and improving immunisation rates, patient safety, experience and outcomes [2,3,4,5,6]
Summary
The need for information exchange and integrated care has stimulated the development of interoperability solutions that bring together patient data across the health and care system to enable effective information sharing. HIE solutions have been shown to provide a variety of benefits to health care systems, such as minimising gaps in patient histories, avoiding unnecessary duplication of procedures and investigations, reducing hospital admissions, referrals, and costs, and improving immunisation rates, patient safety, experience and outcomes [2,3,4,5,6]. These improvements are important considering the shift to more integrated care models that require multiple providers in a local area to work together to achieve greater integration of health and social care services and improve population health.
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