# Improving healthcare processes and outcomes by directly integrating health information exchange data in the clinical workflow

> **NIH AHRQ R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $344,396

## Abstract

Project Summary/Abstract
For clinicians, using patient health information exchanged across healthcare systems is often cumbersome and
disruptive. Systematic reviews report promising effects of health information exchange (HIE) on healthcare
processes and outcomes, such as decreased repeat/unnecessary tests, costs, and admission/readmission
rates. However, until HIE is widely and firmly integrated in the practice and workflow of clinicians, it is unlikely
that we will fully realize the potential benefits of the significant investment in the adoption and use of health
information technologies. Direct integration of HIE and electronic health records (EHR) has not been widely
implemented and studied, offering the opportunity to measure how putting relevant and timely information
directly at the clinician’s fingertips could impact care compared to traditional ways of accessing information in
an HIE. The objective of our project is to evaluate a novel application called CareView that seamlessly
integrates highly relevant information from the HIE directly with the EHR in the emergency department (ED).
Our central hypothesis is that this HIE/EHR integration will increase HIE information use and improve care
delivery, patient outcomes, and clinician satisfaction and efficiency compared to current methods of accessing
HIE data. Our specific aims are to assess the impact of HIE/EHR integration on: (1) clinician perceptions and
acceptance of HIE in the ED setting; (2) HIE use by ED clinicians; and (3) clinical care processes and
outcomes in the ED. Based on our successful 2018 pilot implementation at Indiana University (IU) Health
Methodist, the largest ED in the IU Health system, we will roll out CareView at additional IU Health EDs in
waves of three to four sites for intervention periods of two months in a total of 14 IU Health EDs. Using a
stepped-wedge, cluster non-randomized controlled study design, each site will serve as a control and,
subsequently, intervention site. CareView supports the clinical conditions of chest pain, abdominal pain,
weakness/ dizziness/ headache, back/ flank pain, pregnancy, arrhythmia and dyspnea, and we expect our
study to involve approximately 139 clinicians during nearly 100,000 of the 370,000 annual ED visits in the IU
Health system. Our project is significant because it will evaluate a method to efficiently and effectively retrieve
relevant information from an HIE within an EHR; focus on the ED, where using HIE information is typically
highly relevant and impactful; and generate evidence for the implementation and impact of interoperability, a
key health IT focus of federal, state and other agencies. The project is innovative because it (1) seamlessly
integrates HIE data with the EHR; (2) uses the novel Fast Healthcare Interoperability Resources (FHIR)
standard, which the AHRQ has endorsed, to facilitate generalizability; and (3) employs a rigorous study design
that allows us to make causal inferences about the impact of ...

## Key facts

- **NIH application ID:** 10052274
- **Project number:** 1R01HS027185-01A1
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** TITUS K. SCHLEYER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $344,396
- **Award type:** 1
- **Project period:** 2020-09-30 → 2023-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10052274

## Citation

> US National Institutes of Health, RePORTER application 10052274, Improving healthcare processes and outcomes by directly integrating health information exchange data in the clinical workflow (1R01HS027185-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10052274. Licensed CC0.

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