J Korean Ophthalmol Soc.  2019 Mar;60(3):261-267. 10.3341/jkos.2019.60.3.261.

Effect Analyses of a Health Information Exchange in Ophthalmology: Evidence from a Pilot Program

• Kim JE
• Kim HK
• Rim TH
• Kim YA
• Kim SS

• KMID: 2440454
• DOI: http://doi.org/10.3341/jkos.2019.60.3.261

Abstract

PURPOSE
To estimate the impact of a health information exchange (HIE) pilot project on ophthalmology department care.
METHODS
Study sites included 4 ophthalmic clinics in three regions participating in the HIE pilot project (group A), and 12 clinics with similar distances and numbers of patient referrals as group A but who were not participating in the HIE pilot project (group B). The mean wait time, total medical costs, and ophthalmic examinations of referral patients were analyzed.
RESULTS
The mean wait times were 8.4 ± 8.0 days in group A, which included 83 patients, and 11.7 ± 15.4 days in group B, which included 417 patients. The wait time was significantly shorter in group A (p = 0.005). Sensitivity analyses also indicated shorter wait times in group A. In 247 patients in group B who were referred to tertiary referral hospitals automatically through the conventional clinical cooperation center with group A, the wait times were 8.4 ± 8.0 and 7.7 ± 8.8 days, respectively, and the total cost of medical care was 260.6 ± 271.4 and 257.0 ± 251.7 thousand Won, respectively. No differences in these factors were found between the groups (p = 0.503, 0.913, respectively). There were no significant differences in participation in the HIE pilot project regarding ophthalmic examinations conducted within 2 weeks since patient referral (p > 0.050 for all).
CONCLUSIONS
The HIE is advantageous because it results in shorter wait times to see an ophthalmologist, due to the automatic referral method based on medical records. However, there are no benefits in reducing total costs of medical care or the number of clinical examinations.

Keyword

Health communication; Health information exchange; Tertiary healthcare

MeSH Terms

Health Communication
Health Information Exchange*
Humans
Medical Records
Methods
Ophthalmology*
Pilot Projects
Referral and Consultation
Tertiary Care Centers
Tertiary Healthcare

Figure

• 

  Figure 1 Study design. Four clinics were selected for participation in HIE (experimental group). For the control group, three times the number of HIE-participating clinics in the same districts were selected based on similar size (similar numbers of referral patients) and similar distances from the tertiary medical institution. HIE = health information exchange.

• 

  Figure 2 Study subjects selection flow. Study subjects were 83 patients from 4 HIE participating clinics and 417 patients from 12 non-HIE participating clinics. HIE = health information exchange.

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