Health Information Exchange Platform for Improving Patient Transfers

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Brigham and Women's Hospital

Disqualifiers: Age < 18, ER admission, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

1000 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Health Information Exchange (HIE) platform?

Research shows that Health Information Exchange (HIE) can improve patient safety by reducing errors and adverse drug events, enhance patient satisfaction through better communication, and potentially improve care quality in emergency departments. ^{1 2 3 4 5}

Is the Health Information Exchange (HIE) platform safe for use in humans?

The Health Information Exchange (HIE) platform is generally considered safe and can improve patient safety by reducing errors and adverse drug events through better access to patient information. ^{1 4 6 7 8}

How does this treatment differ from other treatments for patient transfers?

This treatment is unique because it uses a Health Information Exchange (HIE) platform to electronically share patient information between different healthcare organizations, which can improve the efficiency and safety of patient transfers compared to traditional methods that rely on paper records or isolated electronic systems. ^{4 7 9 10 11}

What is the purpose of this trial?

Sub-optimal transfer of clinical information during inter-hospital transfer (IHT, the transfer of patients between acute care hospitals) is common and can lead to patient harm. To address this problem, the investigators will use key stakeholder input to refine and implement an interoperable health information exchange platform that integrates with the electronic health record and improves the reliability of and access to necessary clinical information in three use cases involving transfer of patients between sending and receiving hospitals with varying levels of affiliation and health record integration. The investigators will assess the effect of this intervention on frequency of medical errors, evaluate the use and usability of this platform from the perspective of those that interact with it, and use these results to develop a dissemination plan to spread implementation and use of this platform across other similar institutions.

Eligibility Criteria

This trial is for adults over 18 who are admitted to general medicine, cardiology, oncology, or ICU services at Brigham and Women's Hospital and transferred from one of these hospitals: Brigham and Women's Faulkner Hospital, South Shore Hospital, Milford Regional Medical Center. It excludes those under 18 or admitted through ER or directly from home/clinic.

Inclusion Criteria

Transferred from one of the 3 included transferring hospitals (Brigham and Women's Faulkner Hospital, South Shore Hospital, Milford Regional Medical Center)

Admitted to the general medical, cardiology, oncology, and/or ICU services at Brigham and Women's Hospital

Exclusion Criteria

I am under 18 years old.

Transferred from a different acute care hospital than the 3 included hospitals

I am coming directly from home or a clinic.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

The baseline arm will include all included patient transfers from the 3 participating transfer hospitals to the 1 accepting hospital during the 1-year pre-intervention phase. They will not receive any intervention, but rather usual care.

1 year

Intervention

The intervention arm will include all included patient transfers from the 3 participating transfer hospitals to the 1 accepting hospital during the 1-year intervention phase. They will receive the intervention, which will include utilization of the developed health information exchange platform to transfer clinical information between transferring and accepting hospital.

1 year

Follow-up

Participants are monitored for safety and effectiveness after treatment, including surveys of admitting clinicians 48-72 hours after patient transfer.

Up to 72 hours after transfer

Treatment Details

Interventions

• Health Information Exchange (HIE) platform

Trial Overview The trial is testing a Health Information Exchange (HIE) platform designed to improve the transfer of patient information between hospitals. The goal is to see if this system reduces medical errors by providing better access to clinical data during inter-hospital transfers.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

The intervention arm will include all included patient transfers from the 3 participating transfer hospitals to the 1 accepting hospital during the 1-year intervention phase. They will receive the intervention, which will include utilization of the developed health information exchange platform to transfer clinical information between transferring and accepting hospital. The intervention will not interact directly with the patient, but rather their clinical data.

Group II: Baseline Active Control 1 Intervention

The baseline arm will include all included patient transfers from the 3 participating transfer hospitals to the 1 accepting hospital during the 1-year pre-intervention phase. They will not receive any intervention, but rather usual care

Who Is Running the Clinical Trial?

Brigham and Women's Hospital

Lead Sponsor

Trials

1,694

Recruited

14,790,000+

Agency for Healthcare Research and Quality (AHRQ)

Collaborator

Trials

415

Recruited

6,777,000+

References

1. United States pubmed.ncbi.nlm.nih.gov

Health information exchange and patient safety. [2022]

2. Germany pubmed.ncbi.nlm.nih.gov

The association between health information exchange and measures of patient satisfaction. [2022]

3. Ireland pubmed.ncbi.nlm.nih.gov

The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review. [2018]

4. Germany pubmed.ncbi.nlm.nih.gov

How could health information exchange better meet the needs of care practitioners? [2018]

5. England pubmed.ncbi.nlm.nih.gov

Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments. [2019]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Qualitative study of patient consent for health information exchange in an HIV clinic. [2017]

7. Canada pubmed.ncbi.nlm.nih.gov

Outcomes From Health Information Exchange: Systematic Review and Future Research Needs. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Registered Nurses' and Medical Doctors' Experiences of Patient Safety in Health Information Exchange During Interorganizational Care Transitions: A Qualitative Review. [2023]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Health information exchange: national and international approaches. [2019]

10. Germany pubmed.ncbi.nlm.nih.gov

A case report in health information exchange for inter-organizational patient transfers. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

The implications and impact of 3 approaches to health information exchange: community, enterprise, and vendor-mediated health information exchange. [2023]