{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T09:18:48Z","timestamp":1768468728758,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Even with different HIE approaches across countries, all clinicians reported shortcomings in their country\u2019s approach. Notably, challenges were similar and shaped the conditions under which PMH was sought.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jamia\/ocx153","type":"journal-article","created":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T04:07:33Z","timestamp":1513570053000},"page":"686-693","source":"Crossref","is-referenced-by-count":12,"title":["A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care"],"prefix":"10.1093","volume":"25","author":[{"given":"Seth","family":"Klapman","sequence":"first","affiliation":[{"name":"Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Sher","sequence":"additional","affiliation":[{"name":"Office of Medical Education, A.T. Still University of Osteopathic Medicine, Mesa, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Adler-Milstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,2,2]]},"reference":[{"key":"2020110612224540500_ocx153-B1","doi-asserted-by":"crossref","article-title":"Integrating data from EHRs to enhance clinical decision making: the inflammatory bowel disease case","author":"Abouzahra","DOI":"10.1109\/CBMS.2014.124"},{"key":"2020110612224540500_ocx153-B2","first-page":"1","article-title":"Electronic health records: an international perspective on \u201cmeaningful use.\u201d","volume":"28","author":"Gray","year":"2011","journal-title":"The Commonwealth Fund."},{"key":"2020110612224540500_ocx153-B3","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1089\/big.2015.29001.mcr","article-title":"Big data in healthcare: opportunities and challenges","volume":"3","author":"Craven","year":"2015","journal-title":"Big Data."},{"issue":"Jan\u2013Jun (Suppl Web Exclusives)","key":"2020110612224540500_ocx153-B4","doi-asserted-by":"crossref","first-page":"W5-19","DOI":"10.1377\/hlthaff.W5.19","article-title":"Interoperability: the key to the future health care system","author":"Brailer","year":"2005","journal-title":"Health Aff (Millwood)."},{"key":"2020110612224540500_ocx153-B5","first-page":"1","article-title":"Electronic medical record adoption in New Zealand primary care physician offices","volume":"96","author":"Protti","year":"2010","journal-title":"The Commonwealth Fund."},{"key":"2020110612224540500_ocx153-B6","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1377\/hlthaff.2012.0884","article-title":"A survey of primary care doctors in ten countries shows progress in use of health information technology, less in other areas","volume":"31","author":"Schoen","year":"2012","journal-title":"Health Aff (Millwood)."},{"key":"2020110612224540500_ocx153-B7","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1001\/jama.2015.5930","article-title":"On the road to interoperability, public and private organizations work to connect health care data","volume":"314","author":"Jacob","year":"2015","journal-title":"JAMA."},{"key":"2020110612224540500_ocx153-B8","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/jamia\/ocw111","article-title":"International health IT benchmarking: learning from cross-country comparisons","volume":"24","author":"Zelmer","year":"2017","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612224540500_ocx153-B9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/1472-6963-11-114","article-title":"Missing clinical information in NHS hospital outpatient clinics: prevalence, causes and effects on patient care","volume":"11","author":"Burnett","year":"2011","journal-title":"BMC Health Serv Res."},{"key":"2020110612224540500_ocx153-B10","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1197\/jamia.M2507","article-title":"Emergency physicians\u2019 perceptions of health information exchange","volume":"14","author":"Shapiro","year":"2007","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612224540500_ocx153-B11","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.annemergmed.2013.09.024","article-title":"Emergency physicians\u2019 perspectives on their use of health information exchange","volume":"63","author":"Thorn","year":"2014","journal-title":"Ann Emerg Med."},{"key":"2020110612224540500_ocx153-B12","volume-title":"International Profiles of Health Care Systems, 2014","author":"Mossialos"},{"key":"2020110612224540500_ocx153-B13","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1136\/jamia.2009.000505","article-title":"The design and evaluation of a graphical display for laboratory data","volume":"17","author":"Bauer","year":"2010","journal-title":"J Am Med Inform Assoc."},{"key":"2020110612224540500_ocx153-B14","doi-asserted-by":"crossref","first-page":"e135","DOI":"10.1016\/j.ijmedinf.2008.07.008","article-title":"A longitudinal study of usability in health care: does time heal?","volume":"79","author":"Kjeldskov","year":"2010","journal-title":"Int J Med Inform."},{"key":"2020110612224540500_ocx153-B15","first-page":"48","article-title":"Clinical data exchange models. 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