• Mustafa Ozkaynak and Patricia Flatley Brennan.
• Industrial Engineering, Worcester Polytechnic Institute, Worcester, MA 01605-2661, USA. mozkaynak@wpi.edu
• J Eval Clin Pract. 2013 Apr 1; 19 (2): 370-3.

BackgroundHealth information exchange (HIE) allows clinicians to access patient level health care information. HIE can potentially improve patient care in emergency departments.MethodsWe present a selected piece of evaluation of an HIE implementation in three Midwestern emergency departments. Data were collected through over 210 hours of direct observations and short interviews with 13 clinicians.ResultsThe results suggest that the usage rate of the HIE was low. Moreover, two ways of unreported use of the HIE system by clinicians was uncovered: (1) The HIE system was being used mostly for patients only with specific characteristics. (2) The information from the HIE system could be used to confront with the patients.DiscussionThis study provides a case of how social system may shape a HIE technology. In order to fully benefit from HIE, understanding organizational and social context during the HIE design and implementation is needed. Such an understanding will also allow us to identify and detail required additional resources and organizational interventions that will complement HIE such as a case management strategy.© 2012 Blackwell Publishing Ltd.

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