{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:24:08Z","timestamp":1775665448854,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"e1","funder":[{"name":"Research and Quality Mentored Clinical Scientist Research Career Development","award":["(K08 HS024160)"],"award-info":[{"award-number":["(K08 HS024160)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:p>Objective: To assess whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations.<\/jats:p><jats:p>Materials and Methods: Our data included 2163 patients seen in the ED of a large academic medical center for whom clinicians requested and viewed outside information from February 14, 2014, to February 13, 2015. Outside information requests w.ere fulfilled via HIE (Epic\u2019s Care Everywhere) or fax\/scan to the electronic health record (EHR). We used EHR audit data to capture the time between the information request and when a clinician accessed the data. We assessed whether the relationship between method of information return and ED outcomes (length of visit, odds of imaging [computed tomography (CT), magnetic resonance imaging (MRI), radiographs] and hospitalization, and total charges) was mediated by request-to-access time, controlling for patient demographics, case mix, and acuity.<\/jats:p><jats:p>Results: In multivariate analysis, there was no direct association between return of information via HIE vs fax\/scan and ED outcomes. HIE was associated with faster outside information access (58.5\u2009minutes on average), and faster access was associated with changes in ED care. For each 1-hour reduction in access time, visit length was 52.9\u2009minutes shorter, the likelihood of imaging was lower (by 2.5, 1.6, and 2.4 percentage points for CT, MRI, and radiographs, respectively), the likelihood of admission was 2.4 percentage points lower, and average charges were $1187 lower (P\u2009\u2264\u2009.001 for all).<\/jats:p><jats:p>Conclusion: The relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations.<\/jats:p>","DOI":"10.1093\/jamia\/ocw116","type":"journal-article","created":{"date-parts":[[2016,8,13]],"date-time":"2016-08-13T00:49:15Z","timestamp":1471049355000},"page":"e103-e110","source":"Crossref","is-referenced-by-count":61,"title":["Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations"],"prefix":"10.1093","volume":"24","author":[{"given":"Jordan","family":"Everson","sequence":"first","affiliation":[{"name":"Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor"}]},{"given":"Keith E","family":"Kocher","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"}]},{"given":"Julia","family":"Adler-Milstein","sequence":"additional","affiliation":[{"name":"School of Information and Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor"}]}],"member":"286","published-online":{"date-parts":[[2016,8,12]]},"reference":[{"key":"2020110612434366600_ocw116-B1","volume-title":"To Err Is Human: Building a Safer Health System","author":"Kohn","year":"2000"},{"issue":"10","key":"2020110612434366600_ocw116-B2","first-page":"1023","article-title":"Prevalence of information gaps in the emergency department and the effect on patient outcomes","volume":"169","author":"Stiell","year":"2003","journal-title":"CMAJ."},{"key":"2020110612434366600_ocw116-B3","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1136\/amiajnl-2010-000021","article-title":"Health-information exchange: why are we doing it, and what are we doing?","volume":"18","author":"Kuperman","year":"2011","journal-title":"J Am Med Inform Assoc."},{"issue":"3","key":"2020110612434366600_ocw116-B4","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1377\/hlthaff.2011.1314","article-title":"From the office of the National Coordinator: the strategy for advancing the exchange of health information","volume":"31","author":"Williams","year":"2012","journal-title":"Health Aff (Millwood)."},{"issue":"6","key":"2020110612434366600_ocw116-B5","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/j.jbi.2007.08.004","article-title":"Estimated financial savings associated with health information exchange and ambulatory care referral","volume":"40","author":"Frisse","year":"2007","journal-title":"J Biomed Inform."},{"key":"2020110612434366600_ocw116-B6","doi-asserted-by":"crossref","first-page":"W5","DOI":"10.1377\/hlthaff.W5.10","article-title":"The value of health care information exchange and interoperability","volume":"24","author":"Walker","year":"2005","journal-title":"Health Aff (Millwood)."},{"key":"2020110612434366600_ocw116-B7","volume-title":"Crossing the Quality Chasm: a New Health System for the 21st Century","author":"Institute of Medicine","year":"2001"},{"issue":"2","key":"2020110612434366600_ocw116-B8","first-page":"176","article-title":"Does health information exchange reduce unnecessary neuroimaging and improve quality of headache care in the emergency department? 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