Electronic Information Exchange Research Articles

Exploring the impact of primary care utilization and health information exchange upon treatment patterns and clinical outcomes of glioblastoma patients.

There is limited literature describing care coordination for patients with glioblastoma (GBM). We aimed to investigate the impact of primary care and electronic health information exchange (HIE) between neurosurgeons, oncologists, and primary care providers (PCP) on GBM treatment patterns, postoperative outcomes, and survival. We identified adult GBM patients undergoing primary resection at our institution (2007-2020). HIE was defined as shared electronic medical information between PCPs, oncologists, and neurosurgeons. Multivariate logistic regression analyses were used to determine the effect of PCPs and HIE upon initiation and completion of adjuvant therapy. Kaplan-Meier and multivariate Cox regression models were used to evaluate overall survival (OS). Among 374 patients (mean age ± SD: 57.7 ± 13.5, 39.0% female), 81.0% had a PCP and 62.4% had electronic HIE. In multivariate analyses, having a PCP was associated with initiation (OR: 7.9, P < 0.001) and completion (OR: 4.4, P < 0.001) of 6 weeks of concomitant chemoradiation, as well as initiation (OR: 4.0, P < 0.001) and completion (OR: 3.0, P = 0.007) of 6 cycles of maintenance temozolomide thereafter. Having a PCP (median OS [95%CI]: 14.6[13.1-16.1] vs. 10.8[8.2-13.3] months, P = 0.005) and HIE (15.40[12.82-17.98] vs. 13.80[12.51-15.09] months, P = 0.029) were associated with improved OS relative to counterparts in Kaplan-Meier analysis and in multivariate Cox regression analysis (hazard ratio [HR] = 0.7, [95% CI] 0.5-1.0, P = 0.048). In multivariate analyses, chemoradiation (HR = 0.34, [95% CI] 0.2-0.7, P = 0.002) and maintenance temozolomide (HR = 0.5, 95%CI 0.3-0.8, P = 0.002) were associated with improved OS relative to counterparts. Effective care coordination between neurosurgeons, oncologists, and PCPs may offer a modifiable avenue to improve GBM outcomes.

Is Electronic Information Exchange Associated With Lower 30-Day Readmission Charges Among Medicare Beneficiaries?

Fragmented readmissions, when admission and readmission occur at different hospitals, are associated with increased charges compared with nonfragmented readmissions. We assessed if hospital participation in health information exchange (HIE) was associated with differences in total charges in fragmented readmissions. Medicare Fee-for-Service Data, 2018. We used generalized linear models with hospital referral region and readmission month fixed effects to assess relationships between information sharing (same HIE, different HIEs, and no HIE available) and total charges of 30-day readmissions among fragmented readmissions; analyses were adjusted for patient-level clinical/demographic characteristics and hospital-level characteristics. We included beneficiaries with a hospitalization for acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, syncope, urinary tract infection, dehydration, or behavioral issues with a 30-day readmission for any reason. In all, 279,729 admission-readmission pairs were included, 27% of which were fragmented (n=75,438); average charges of fragmented readmissions were $64,897-$71,606. Compared with fragmented readmissions where no HIE was available, the average marginal effects of same-HIE and different-HIE admission-readmission pairs were -$2329.55 (95% CI: -7333.73, 2674.62) and -$3905.20 (95% CI: -7592.85, -307.54), respectively. While the average marginal effects of different-HIE pairs were lower than those for no-HIE fragmented readmissions, the average marginal effects of same-HIE and different-HIE pairs were not significantly different from each other. There were no statistical differences in charges between fragmented readmissions to hospitals that share an HIE or that do not share an HIE compared with hospitals with no HIE available.

IJCM_272A: Development of a Framework for Health Information Exchange and Interoperability in a group of Teaching Hospitals: A Qualitative Study

Background: Health information exchange (HIE) is the electronic exchange of data or information between healthcare institutions, despite the fact that, the format and context of the information may vary. A robust HIE, which provides the seamless networking is not currently available. The gap in research pertaining mainly to Indian scenario where this study will be proposed would provide the much-needed evidence. The proposed study aims to develop a comprehensive framework for Health information exchange and interoperability for a group of teaching hospitals. Objectives: To understand and assess the current state, barriers and challenges related to HIE and interoperability; understand the perspectives and challenges of HIE and Interoperability among healthcare providers. Methodology: A qualitative study would be carried out among healthcare stakeholders which will serve in understanding the perspective and challenges of HIE and interoperability and develop a comprehensive framework for HIE and interoperability. Results: Coordinated care among the healthcare providers can be increased and serves in reducing the lost to follow up of patients which promotes patient quality of life and lowers the rate of mortality and morbidity. This will facilitate the quick access to the patient critical information, leading to better – informed diagnosis and treatment plans. This framework will significantly elevate the quality of care, streamline operations, will contribute to a reduction in mortality and morbidity.

Цифровизация нотариата как фактор создания единого нотариального пространства в Евразийском экономическом союзе

The article discusses the need to create a Unified Notary Information System in the Eurasian Economic Union, which will allow advancement to a higher level of economic cooperation, lead to more effective development of civil legal relations, and allow for electronic exchange of information and documents. The procedure for reg-istration and execution of notarial acts has been studied; the amount of information to be recorded, as well as methods for recording it. A comparative analysis of the legislation of the member states of the Eurasian Eco-nomic Union regulating notarial activities was carried out. The procedure and method of collecting information, the level of security of documents, and the possibility of conducting verification activities to determine the au-thenticity of the submitted documents are considered. The subject of comparison is the degree of use of digital technologies within the framework of the electronic exchange of information and documents between partici-pants in civil transactions (notaries, citizens, legal entities). Attention is focused on analyzing the degree of im-plementation of digital technologies within the framework of storing notarial documents. The capabilities of notaries to provide notarial services are considered, including the ability to collect information necessary to per-form a notarial act, and information necessary to formalize inheritance rights. The powers of notaries in the framework of interaction with state registers have been studied, including the powers to carry out verification actions in relation to applicants, register rights to movable and immovable property, to introduce encumbrances on movable and immovable property, as well as to make changes to the information contained in state regis-ters. The subject of comparison was the degree of digital technology usage in the process of storage of notarial documents, as well as in the framework of electronic exchange of information between participants of civil turnover (notaries, individuals and legal entities). Prospects for further research in this area are defined.

Exploring the Implementation Challenges of the Electronic Freight Transport Information (eFTI) Regulation: An Empirical Perspective from Greece

Background: The electronic Freight Transport Information (eFTI) regulation is critical in modernizing freight transport (FT) within the European Union by establishing a framework for the electronic exchange of information. Despite its importance, there is a notable gap in the literature regarding the practical implementation challenges, especially from an empirical perspective. Methods: To address this gap, our study utilized a grounded theory approach, conducting interviews with a diverse group of logistics experts from Greece. The selection of experts was strategic to ensure a comprehensive range of knowledge and expertise, including insights at the policy level as well as practical experiences. Results: Our findings highlight several significant challenges in the implementation of eFTI, including the digital skill gap among the workforce, issues with system interoperability, and diverse capacities and resources of companies of different sizes. Economic factors, regulatory frameworks and the necessity for targeted training and leadership support were also identified as crucial for the digital transition. Conclusions: The study shows that uniform eFTI implementation may not work for all organizations, highlighting the necessity for customized strategies that address specific challenges in the FT chain. Our research deepens the understanding of these issues, providing actionable insights for successful eFTI adoption.

Impact of electronic information exchange on repeat imaging during 30-day readmissions among Medicare beneficiaries.

We examined the association between electronic health information sharing and repeat imaging in readmissions among older adults with and without Alzheimer disease (AD). Cohort study using national Medicare data. Among Medicare beneficiaries with 30-day readmissions in 2018, we examined repeat imaging on the same body system during the readmission. This was evaluated between fragmented and nonfragmented (same-hospital) readmissions and across categories of electronic information sharing via health information exchanges (HIEs) in fragmented readmissions: admission and readmission hospitals share the same HIE, admission and readmission hospitals participate in different HIEs, one or both do not participate in HIE, or HIE data missing. This relationship was evaluated using unadjusted and adjusted logistic regression. Overall, 14.3% of beneficiaries experienced repeat imaging during their readmission. Compared with nonfragmented readmissions, fragmented readmissions were associated with 5% higher odds of repeat imaging on the same body system in older adults without AD. This was not mitigated by the presence of electronic information sharing: Fragmented readmissions to hospitals that shared an HIE had 6% higher odds of repeat imaging (adjusted OR, 1.06; 95% CI, 1.00-1.13). There was no difference seen in the odds of repeat imaging for older adults with AD. Despite substantial investment, HIEs as currently deployed and used are not associated with decreased odds of repeat imaging in readmissions.

Preventable Emergency Department Visits of Patients with Alzheimer's Disease and Related Dementias During the COVID-19 Pandemic by Hospital-Based Health Information Exchange.

Background: This study examined the relationship between hospital-based electronic health information exchange (HIE) and the likelihood of having a preventable emergency department (ED) visit during the COVID-19 pandemic for US patients with Alzheimer's Disease and Related Dementias (ADRD). Methods: We used multi-level data from six states. The linked data sets included the 2020 State Emergency Department Databases (SEDD), the Area Health Resources File, the American Hospital Association (AHA) Annual Survey, and the AHA Information Technology Supplement to study 85,261 hospital discharges from patients with ADRD. Logistic regression models were produced to determine the odds of having a preventable ED visit among patients with ADRD. Results: Our final sample included 85,261 hospital discharges from patients with ADRD. Patients treated in hospitals that received more types of clinical information for treating patients with COVID-19 from outside providers (OR = 0.961, p < .05) and/or hospitals that received COVID-19 test results from more outside entities were significantly less likely to encounter preventable EDs (OR = 0.964, p < .05), especially among patients who also had multiple chronic conditions (MCC) (OR = 0.89, p = .001; OR = 0.856, p < .001). Conclusion: Our results suggest that electronic HIE may be useful for reducing preventable ED visits during the COVID-19 pandemic for people with ADRD and ADRD alongside MCC.

THE MODEL OF INFORMATION MESSAGE OF MONITORING RESULTS IN CASE EMERGENCIES OR EMERGENCY THREATS IN THE BORDER ZONES OF RADIOACTIVE CONTAMINATION IN RUSSIA AND BELARUS

The article describes model of the structure of the interstate information message is presented task is prompt and detailed transfer of information on emergency situations and their consequences through the automated systems of data exchange between the regional departments of the EMERCOM of Russia (Bryansk region) and the EMERCOM of the Republic of Belarus of border areas (Gomel and Mogilev regions).The digital representation of the data in the message is based on the use of joint electronic directories: on the settlements in Gomel and Mogilev regions of the Republic of Belarus, Bryansk region of the Russian Federation; on interstate standards on radiation remedial measures and electronic exchange of information; on emergencies and their scale; on weather conditions. The structure of an electronic message has been developed on the basis of a number of joint electronic directories designed to support information exchange procedures, provided that the volume of transmitted data is minimized and the level of detail about emergencies and/or their threats in the zones of radioactive contamination of the border areas of Russia and Belarus is expanded.

Wybrane systemy współpracy międzynarodowej w zakresie zapewniania bezpieczeństwa osób zaginionych

The article analyses selected systems of international cooperation in ensuring the safety of missing persons. The study indicates the categories of missing persons, the procedures regulating the conduct of a police officer in the case of a missing person, the documentation of search activities, the scale and causes of disappearances and the cooperation of institutions and non-governmental organisations in the search for a missing person. Improving the circulation of information between Police organisational units concerning disappearances outside the Republic of Poland is an important task of the institution through the dissemination of electronic exchange of information, in particular with regard to the categorisation of missing persons. Authors believes that it is important to take steps to enlist new groups to extend their reach to cover both domestic and international areas, thereby affecting the efficient and effective operations of the Police in conducting searches for missing persons both domestically and internationally.

Assessing the impact of health information exchange on hospital data breach risk

ObjectiveWidespread electronic health information exchange (HIE) across hospitals remains an important policy goal for reducing costs and improving the quality of care. Meanwhile, cybersecurity incidents are a growing threat to hospitals. The relationship between the electronic sharing of health information and cybersecurity incidents is not well understood. The objective of this study was to empirically examine the impact of hospitals’ HIE engagement on their data breach risk. Materials and MethodsA balanced panel dataset included 4,936 US community hospitals spanning the period 2010–2017, which was assembled by linking the American Hospital Association annual survey database and the Information Technology (IT) supplement, and the Department of Health and Human Services reports of health data breaches. The relationship between HIE engagement and hospital data breaches was modeled using a difference-in-differences specification controlling for time-varying hospital characteristics. ResultsThe percentage of hospitals electronically exchanging information has more than tripled (from 18% to 68%) from 2010 to 2017. Hospital data breaches increased concurrently, largely due to the rise in hacking and unauthorized access. HIE engagement was associated with a 0.672 percentage point increase in the probability of an IT breach three years after the engagement. Hospitals actively engaging in a health information organization and exchanging data with outside providers were associated with a higher risk of IT related breaches in the long run; however, hospitals actively engaging in HIE and exchanging data with inside providers were not associated with any significant risk of IT related breaches. DiscussionOver time, the increasing amount and complexity of patient information being exchanged can create challenges for cybersecurity if data protection is not up to date. Additionally, data security depends on the weakest link of HIE, and providers with fewer resources for data governance and infrastructure are more vulnerable to data breaches. ConclusionMoving toward widespread health information exchange has important cybersecurity implications that can significantly impact both patients and healthcare organizations.

Optimal Care for Kidney Health: Development of a Merit-based Incentive Payment System (MIPS) Value Pathway.

The Merit-based Incentive Payment System (MIPS) is a mandatory pay-for-performance program through the Centers for Medicare & Medicaid Services (CMS) that aims to incentivize high-quality care, promote continuous improvement, facilitate electronic exchange of information, and lower health care costs. Previous research has highlighted several limitations of the MIPS program in assessing nephrology care delivery, including administrative complexity, limited relevance to nephrology care, and inability to compare performance across nephrology practices, emphasizing the need for a more valid and meaningful quality assessment program. This article details the iterative consensus-building process used by the American Society of Nephrology Quality Committee from May 2020 to July 2022 to develop the Optimal Care for Kidney Health MIPS Value Pathway (MVP). Two rounds of ranked-choice voting among Quality Committee members were used to select among nine quality metrics, 43 improvement activities, and three cost measures considered for inclusion in the MVP. Measure selection was iteratively refined in collaboration with the CMS MVP Development Team, and new MIPS measures were submitted through CMS's Measures Under Consideration process. The Optimal Care for Kidney Health MVP was published in the 2023 Medicare Physician Fee Schedule Final Rule and includes measures related to angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use, hypertension control, readmissions, acute kidney injury requiring dialysis, and advance care planning. The nephrology MVP aims to streamline measure selection in MIPS and serves as a case study of collaborative policymaking between a subspecialty professional organization and national regulatory agencies.

A Privacy-Preserving Scheme for Managing Secure Data in Healthcare System

In the world of modern technology and the huge spread of its use, it has been combined with healthcare systems and the establishment of electronic health records (EHR) to follow up on patients. This merging of technology with healthcare has allowed for more accurate EHRs that follow a patient to different healthcare facilities. Timely exchange of electronic health information (EHR) between providers is critical for aiding medical research and providing fast patient treatment. As a result, security issues and privacy problems are viewed as significant difficulties in the healthcare system. Several remote user authentication methods have been suggested. In this research, we present a feasible patient EHR migration solution for each patient. finally, each patient may securely delegate their current hospital’s information system to a hospital certification authority in order to receive migration proof that can be used to transfer their EHR to a different hospital. In addition, the proposed scheme is based on crypto-hash functions and asymmetric cryptosystems by using homomorphic cryptography. The proposed scheme carried out two exhaustive formal security proofs for the work that was provided. Using Scyther, a formal security tool, we present a secure user authentication technique in the proposed healthcare scheme that ensures security and informal analysis.

Association of Fragmented Readmissions and Electronic Information Sharing With Discharge Destination Among Older Adults

When an older adult is hospitalized, where they are discharged is of utmost importance. Fragmented readmissions, defined as readmissions to a different hospital than a patient was previously discharged from, may increase the risk of a nonhome discharge for older adults. However, this risk may be mitigated via electronic information exchange between the admission and readmission hospitals. To determine the association of fragmented hospital readmissions and electronic information sharing with discharge destination among Medicare beneficiaries. This cohort study retrospectively examined data from Medicare beneficiaries hospitalized for acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, syncope, urinary tract infection, dehydration, or behavioral issues in 2018 and their 30-day readmission for any reason. The data analysis was completed between November 1, 2021, and October 31, 2022. Same hospital vs fragmented readmissions and presence of the same health information exchange (HIE) at the admission and readmission hospitals vs no information shared between the admission and readmission hospitals. The main outcome was discharge destination following the readmission, including home, home with home health, skilled nursing facility (SNF), hospice, leaving against medical advice, or dying. Outcomes were examined for beneficiaries with and without Alzheimer disease using logistic regressions. The cohort included 275 189 admission-readmission pairs, representing 268 768 unique patients (mean [SD] age, 78.9 [9.0] years; 54.1% female and 45.9% male; 12.2% Black, 82.1% White, and 5.7% other race and ethnicity). Of the 31.6% fragmented readmissions in the cohort, 14.3% occurred at hospitals that shared an HIE with the admission hospital. Beneficiaries with same hospital/nonfragmented readmissions tended to be older (mean [SD] age, 78.9 [9.0] vs 77.9 [8.8] for fragmented with same HIE and 78.3 [8.7] years for fragmented without HIE; P < .001). Fragmented readmissions were associated with 10% higher odds of discharge to an SNF (adjusted odds ratio [AOR], 1.10; 95% CI, 1.07-1.12) and 22% lower odds of discharge home with home health (AOR, 0.78; 95% CI, 0.76-0.80) compared with same hospital/nonfragmented readmissions. When the admission and readmission hospital shared an HIE, beneficiaries had 9% to 15% higher odds of discharge home with home health (patients without Alzheimer disease: AOR, 1.09 [95% CI, 1.04-1.16]; patients with Alzheimer disease: AOR, 1.15 [95% CI, 1.01-1.32]) compared with fragmented readmissions where information sharing was not available. In this cohort study of Medicare beneficiaries with 30-day readmissions, whether a readmission is fragmented was associated with discharge destination. Among fragmented readmissions, shared HIE across admission and readmission hospitals was associated with higher odds of discharge home with home health. Efforts to study the utility of HIE for care coordination for older adults should be pursued.

MECHANISMS FOR DETERMINING INNOVATIVE RESOURCES FOR THE FORMATION OF AN INTELLIGENT PRODUCTION SYSTEM IN AGRICULTURE

The article analyzes the resource opportunities for the formation of an integrated system "Smart Production" based on "Smart Agriculture" in the development of agriculture. On the basis of the formation of an integrated platform "Smart Production" based on "Smart Agriculture", the possibilities of applying advanced foreign experience in the national economy were evaluated. Economic criteria for activating the management mechanism are proposed to determine the priority factors for increasing the efficiency of agricultural production entities and improving the living conditions of the population. The features of the model of electronic information exchange of the "Smart Production" platform integrated on the basis of "Smart Agriculture" are presented. He commented on the functional blocks of the organizers of the "Smart Production" system in the production of agricultural products.

Experiences with information blocking in the United States: a national survey of hospitals.

The 21st Century Cures Act Final Rule's information blocking provisions, which prohibited practices likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI), began to apply to a limited set of data elements in April 2021 and expanded to all EHI in October 2022. We sought to describe hospital leaders' perceptions of the prevalence of practices that may constitute information blocking, by actor and hospital characteristics, following the rule's applicability date. Cross-sectional analysis of a national survey of hospitals fielded in 2021. The analytic sample included 2092 nonfederal acute care hospitals in the United States. We present descriptive statistics on the perception of the prevalence of information blocking and results of multivariate regression models examining the association between hospital, health information technology (IT) developer and market characteristics and the perception of information blocking. Overall, 42% of hospitals reported observing some behavior they perceived to be information blocking. Thirty-six percent of responding hospitals perceived that healthcare providers either sometimes or often engaged in practices that may constitute information blocking, while 17% and 19% perceived that health IT developers (such as EHR developers) and State, regional and/or local health information exchanges did the same, respectively. Prevalence varied by health IT developer market share, hospital for-profit status, and health system market share. These results support the value of efforts to further reduce friction in the exchange of EHI and support the need for continued observation to provide a sense of the prevalence of information blocking practices and for education and awareness of information blocking regulations.

Assessing the effect of electronic health information exchange on the completeness and validity of data for measuring viral load testing turnaround time in Nigeria

IntroductionImplementation of health information exchange has been shown to result in several benefits which includes the improvement in the completeness and timeliness of data for public health program monitoring and surveillance. ObjectiveThe objective of this study was to assess the effect of implementing an electronic health information exchange (HIE) on the quality of data available to measure HIV viral load testing turnaround time (TAT) in Nigeria. MethodsWe measured viral load data validity and completeness before the implementation of electronic health information exchange, and 6 months after implementation. Records of specimens collected at 30 healthcare facilities and tested in 3 Polymerase Chain Reaction (PCR) labs were analyzed. We define data completeness as the percentage of non-missing values and measured this value by specimens and by data elements in the dataset for calculating TAT. To examine data validity, we classified TAT segments with negative values and date fields that were not in International Organization for Standardization(ISO) standard date format as invalid. Validity was measured by specimens and by each TAT segment. Pearson’s chi square was used to assess for improvements in validity and completeness post implementation of HIE. Results15,226 records of specimens were analyzed at baseline and 18,022 records of specimens analyzed at endline. Data completeness for all specimens recorded increased significantly from 47% before HIE implementation to 67% six months after implementation (p < 0.01). Data validity also increased from 90% before implementation to 91% after implementation (p < 0.01) ConclusionOur study demonstrated evidence of significant improvement in the quality of data available to measure viral load turnaround time with the implementation of HIE.

Information marketing: the essence, characteristics, and trends of development

Under conditions of fierce competition, when it is important for the manufacturer to acquaint the audience with the unique properties of a product or service, the importance of marketing significantly increases, and the modern realities of digitalization of all spheres of business lead to the fact that most promotional tools are somehow or other related to information technology. Therefore, information marketing today forms the basis among other types of marketing and in recent years is gaining considerable popularity. Given the relevance of the topic, the purpose of the article is to determine the essence, trends, and features of information marketing for modern enterprises. In the course of the research general scientific and special scientific methods of research were used, the principles of objectivity, scientific concretization, and consistency were observed. For the reception of objective scientific result of research 23 scientific works on the chosen problematics where features of modern marketing tools application, in particular, information marketing have been considered have been analyzed. The selection of scientific literature was based on the selection of the most cited and relevant publications on the chosen topic. The selection of materials was made through the use of search platforms and research exchange sites Research Gate, Web Of Science. The results revealed that information marketing can be effectively used for both B2B and B2C segments because today the main part of communication is built through electronic communication and information exchange via the Internet, while the relevance of classic tools such as television advertising, postcards, etc., is gradually lost. Also, the peculiarities of the use of different types of information marketing are specified. In conclusions, it has been proved that for the majority of modern enterprises, the use of information marketing tools is critical as it allows them to maintain their market position and to advance in the direction of widening their audience. Moreover, the development of the list of used tools of information marketing will allow to form the prerequisites for the development of the enterprise.

Design, Development, and Evaluation of an Automated Solution for Electronic Information Exchange Between Acute and Long-term Postacute Care Facilities: Design Science Research.

Information exchange is essential for transitioning high-quality care between care settings. Inadequate or delayed information exchange can result in medication errors, missed test results, considerable delays in care, and even readmissions. Unfortunately, long-term and postacute care facilities often lag behind other health care facilities in adopting health information technologies, increasing difficulty in facilitating care transitions through electronic information exchange. The research gap is most evident when considering the implications of the inability to electronically transfer patients' health records between these facilities. This study aimed to design and evaluate an open standards-based interoperability solution that facilitates seamless bidirectional information exchange between acute care and long-term and postacute care facilities using 2 vendor electronic health record (EHR) systems. Using the design science research methodology, we designed an interoperability solution that improves the bidirectional information exchange between acute care and long-term care (LTC) facilities using different EHR systems. Different approaches were applied in the study with a focus on the relevance cycle, including eliciting detailed requirements from stakeholders in the health system who understand the complex data formats, constraints, and workflows associated with transferring patient records between 2 different EHR systems. We performed literature reviews and sought experts in the health care industry from different organizations with a focus on the rigor cycle to identify the components relevant to the interoperability solution. The design cycle focused on iterating between the core activities of implementing and evaluating the proposed artifact. The artifact was evaluated at a health care organization with a combined footprint of acute and postacute care operations using 2 different EHR systems. The resulting interoperability solution offered integrations with source systems and was proven to facilitate bidirectional information exchange for patients transferring between an acute care facility using an Epic EHR system and an LTC facility using a PointClickCare EHR system. This solution serves as a proof of concept for bidirectional data exchange between Epic and PointClickCare for medications, yet the solution is designed to expand to additional data elements such as allergies, problem lists, and diagnoses. Historically, the interoperability topic has centered on hospital-to-hospital data exchange, making it more challenging to evaluate the efficacy of data exchange between other care settings. In acute and LTC settings, there are differences in patients' needs and delivery of care workflows that are distinctly unique. In addition, the health care system's components that offer long-term and acute care in the United States have evolved independently and separately. This study demonstrates that the interoperability solution improves the information exchange between acute and LTC facilities by simplifying data transfer, eliminating manual processes, and reducing data discrepancies using a design science research methodology.

Exchange of health information among doctors using electronic health records: Facilitators and barriers from a sociotechnical perspective

Electronic health records (EHRs) and other computerized systems facilitate the timely exchange of patients’ health information between providers across different departments and organizations. This study investigates the types and trends of electronic information exchange between doctors and the factors that impact electronic information exchange. We used data from the National Electronic Health Records Survey. Logistic regression models were run to explore the predictors of doctors’ satisfaction with EHRs for information exchange. The models were adjusted to practice type and size and clinical specialty. A total of 1,524 physicians completed cross-sectional questionnaires. Low satisfaction with EHRs was correlated with the inability of providers to exchange information electronically and with difficulty in clinical care documentation. We found that doctors who perceived EHRs to improve their practices’ quality, efficiency, and care coordination were more satisfied with EHRs. They also preferred EHR systems that help them reduce errors (odds ratio (OR) = 2.69, p = 0.008) and prevent duplicate test orderings (OR = 2.33, p = 0.023). Furthermore, factors such as difficulty integrating information into the system, use problems, and time consumption negatively impacted doctors’ perception of EHR use. Doctors’ satisfaction with EHR use was associated with meaningful functionality, namely the ability to enhance care coordination, the ability to improve information availability and quality, work environment and logistic factors, and design characteristics. Improving the design of EHR systems is essential but may not be sufficient for successful and efficient electronic information exchange between doctors. Usability more broadly with data management including external data should be prioritized.

The Development of Export-Import Activity on the Basis of Information and Communication Technologies

Information and communication technologies (ICT) are rapidly becoming a decisive factor and driving force for the development of export-import activities of many enterprises. The aim of the article is to identify the main directions of development of export-import activities on the basis of ICT and to assess the relationship between the indicators of the digital economy and the indicators of exports and imports of the EU countries. In this study, based on the analysis of statistical data of the leading European countries-leaders in the field of exports and imports, the features of their export-import activities are highlighted, the degrees of use of ICT in various sectors of the economy of these countries are analyzed, the most important directions of use of ICT for the development of export-import activities are allocated, namely: digital infrastructure: electronic documentation, electronic exchange of information, e-commerce, digital innovations in the manufacturing, digital finance, digital marketing and promotion, digital logistics, cybersecurity. The allocated areas should serve as a guideline for the resumption of Ukraine’s foreign trade during the wartime and in the post-war period. Taking into consideration data of the EU countries, an analysis of the impact of the indicators of the components of the index of digital economy and society on the volume of exports and imports in 2022 is carried out on the basis of regression models. It is substantiated that the effect of the use of ICT will strengthen our country’s position in the competitive field of international trade. For the leading countries of exports and imports, it is determined that the introduction of 5G technology is of significant importance in the context of the development of foreign trade, which at present is an urgent and strategic direction for the development of these countries. Further direction of development of this study is envisaged in the study of models of dynamics and the inclusion of additional factors influencing foreign trade, namely human potential, financial and material support for the introduction of ICT based on the experience of leading European countries.