Evidence map›Paper›PMID 32179256›Full record

ArticleInternational journal of medical informatics2020

Technology-facilitated care coordination in rural areas: What is needed?

Emily Gill, Patricia C Dykes, Robert S Rudin, Marianne Storm, Kelly McGrath, David W Bates

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of medical informatics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Emily GillBrigham and Women's Hospital and Harvard Medical School, Division of General Internal Medicine and Primary Care, 1620 Tremont Street, 3rd Floor, Boston, 02120-1613, USA. Electronic address: emily.gill@auckland.ac.nz.
Patricia C DykesBrigham and Women's Hospital and Harvard Medical School, Division of General Internal Medicine and Primary Care, 1620 Tremont Street, 3rd Floor, Boston, MA 02120-1613, USA. Electronic address: pdykes@bwh.harvard.edu.
Robert S RudinBoston Office RAND Corporation, 20 Park Plaza, 9th Floor, Suite 920, Boston, MA 02116, USA. Electronic address: Robert_Rudin@rand.org.
Marianne StormFaculty of Health Sciences, Department of Public Health, The University of Stavanger, P.O. Box 8600 Forus, N-4036 Stavanger, Norway. Electronic address: marianne.storm@uis.no.
Kelly McGrathClearwater Valley Orofino Health Center, 1055 Riverside Ave, Orofino, ID 83544, USA. Electronic address: kelly.mcgrath@smh-cvhc.org.
David W BatesBrigham and Women's Hospital and Harvard Medical School, Division of General Internal Medicine and Primary Care, 1620 Tremont Street, 3rd Floor, Boston, MA 02120-1613, USA. Electronic address: dbates@bwh.harvard.edu.

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
NCATS NIH HHS UL1 TR002319
6 · The paper itself

Abstract

backgroundHealth is poorer in rural areas and a major challenge is care coordination for complex chronic conditions. The HITECH and 21 OBJECTIVE AND

methodsUsing semi-structured interviews and surveys, we examined how providers experience electronic health information exchange during care coordination since these Acts were implemented, with a focus on rural settings where health disparities exist. We used a purposive sample that included primary care, acute care hospitals, and community health services in the United States.

findingsWe identified seven themes related to care coordination and information exchange: 'insufficient trust of data'; 'please respond'; 'just fax it'; 'care plans'; 'needle in the haystack'; 're-documentation'; and 'rural reality'. These gaps were magnified when information exchange was required between unaffiliated electronic health records (EHRs) about shared patients, which was more pronounced in rural settings.

conclusionPolicy and incentive modifications are likely needed to overcome the observed health information technology (HIT) shortcomings. Rural settings in the United States accentuate problems that can be addressed through international medical informatics policy makers and the implementation and evaluation of interoperable HIT systems.

Indexed as

Delivery of Health Care, IntegratedDocumentationElectronic Health RecordsFemaleHealth Information ExchangeHealth PersonnelHospital Information SystemsHumansMaleMiddle AgedPrimary Health CareRural PopulationUnited StatesContinuity of patient careElectronic health recordsHealth information ExchangeHealth information technologyPrimary health careRural health

Identifiers

PMID32179256
PMCPMC7603425

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.