SHM Converge Scientific Abstract ePoster Gallery-Health Information Exchange During Interhospital Transfer: A Mixed Methods Evaluation

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This mixed-methods prospective cohort study examined health information exchange (HIE) during inter-hospital transfer (IHT) of 472 medical patients admitted to a tertiary referral hospital from three transferring hospitals with different EHR relationships: same health system/shared EHR, different health system but accessible EHR, and different health system/different EHR. The study included 289 clinician survey responses and 9 user-centered design sessions with 22 clinicians involved in IHT workflows.<br /><br />Survey data from admitting clinicians, collected within 48 hours of admission, assessed the availability and quality of transfer information, as well as the efficiency of care planning. Quantitative and qualitative analyses showed that many clinicians experienced poor or fair access to clinical information, missing data, uncertainty about management, extra time spent learning about the patient, and difficulty providing accurate information. These problems were more pronounced for transfers from hospitals in different health systems, but were present across all transfers.<br /><br />Three main themes emerged from the qualitative analysis. First, clinicians described inefficient access to information due to cumbersome EHR organization, dependence on manual record gathering, difficulty locating notes, labs, and imaging, and limited awareness of EHR functions. Second, they reported incomplete data, including missing contact information, absent or sparse notes, missing transfer reasons, lack of lab trends, limited imaging sharing, and paper medication records that can be lost. Third, clinicians identified communication gaps, including weak written summaries and a need for more verbal follow-up with transferring providers and family members.<br /><br />The study concludes that current HIE processes during IHT remain suboptimal and should focus on improving data access efficiency, completeness, and communication. Efforts should be prioritized for patients transferred from different health systems.

Asset Subtitle

Jazzarae K. Kain

Meta Tag

Author List Jazzarae K. Kain, Pamela M. Garabedian, Stephanie K. Mueller, Stephanie L. Singleton

Category Research

Concept Health Information Exchange

Concept Pediatric Inter-Hospital Transfer

Concept Patient Information

Concept Mixed-Methods Research

Concept Availability

Distinguished Non-Finalist

Presenter Organization Brigham and Women's Hospital

Presenting Author Jazzarae K. Kain

Track Transitions of Care

Keywords

health information exchange

inter-hospital transfer

medical patients

electronic health record

transfer information

clinical communication

data completeness

care planning

tertiary referral hospital

clinician survey

Health Information Exchange

Pediatric Inter-Hospital Transfer

Patient Information

Mixed-Methods Research

Availability