Catherine E Strawley, Julia Adler-Milstein, A Jay Holmgren, Jordan Everson
{"title":"New indices to track interoperability among US hospitals.","authors":"Catherine E Strawley, Julia Adler-Milstein, A Jay Holmgren, Jordan Everson","doi":"10.1093/jamia/ocae289","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To develop indices of US hospital interoperability to capture the current state and assess progress over time.</p><p><strong>Materials and methods: </strong>A Technical Expert Panel (TEP) informed selection of items from the American Hospital Association Health IT Supplement survey, which were aggregated into interoperability concepts (components) and then further combined into indices. Indices were refined through psychometric analysis and additional TEP input. Final indices included a \"Core Index\" measuring adoption of foundational interoperability capabilities, a \"Pathfinder Index\" representing adoption of advanced interoperability technologies and auxiliary exchange activities, and a \"Friction Index\" quantifying barriers. The first 2 indices were scored from 0 (no interoperability) to 100 (full interoperability); the Friction Index was scored 0 (no friction) to 100 (maximum friction). We calculated indices annually from 2021 to 2023, stratifying by hospital characteristics.</p><p><strong>Results: </strong>Items within components created reliable and meaningful measures, and associations between components within indices followed the TEP's expectations. Weighted mean scores for the Core (2023), Pathfinder (2022), and Friction (2023) Indices were 61, 57, and 30, respectively. Hospitals with 500+ beds (large), not designated as critical access, in metropolitan areas, and using market leading electronic health records had statistically significant higher mean scores on all indices. Index values also improved modestly over time.</p><p><strong>Discussion: </strong>Hospitals performed best on the Core Index. Given recent policy and programmatic initiatives, we anticipate continued improvement across all indices.</p><p><strong>Conclusion: </strong>Ongoing index tracking can inform policy impact evaluations and highlight persistent interoperability disparities across hospitals.</p>","PeriodicalId":50016,"journal":{"name":"Journal of the American Medical Informatics Association","volume":" ","pages":"318-327"},"PeriodicalIF":4.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756636/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Medical Informatics Association","FirstCategoryId":"91","ListUrlMain":"https://doi.org/10.1093/jamia/ocae289","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"COMPUTER SCIENCE, INFORMATION SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To develop indices of US hospital interoperability to capture the current state and assess progress over time.
Materials and methods: A Technical Expert Panel (TEP) informed selection of items from the American Hospital Association Health IT Supplement survey, which were aggregated into interoperability concepts (components) and then further combined into indices. Indices were refined through psychometric analysis and additional TEP input. Final indices included a "Core Index" measuring adoption of foundational interoperability capabilities, a "Pathfinder Index" representing adoption of advanced interoperability technologies and auxiliary exchange activities, and a "Friction Index" quantifying barriers. The first 2 indices were scored from 0 (no interoperability) to 100 (full interoperability); the Friction Index was scored 0 (no friction) to 100 (maximum friction). We calculated indices annually from 2021 to 2023, stratifying by hospital characteristics.
Results: Items within components created reliable and meaningful measures, and associations between components within indices followed the TEP's expectations. Weighted mean scores for the Core (2023), Pathfinder (2022), and Friction (2023) Indices were 61, 57, and 30, respectively. Hospitals with 500+ beds (large), not designated as critical access, in metropolitan areas, and using market leading electronic health records had statistically significant higher mean scores on all indices. Index values also improved modestly over time.
Discussion: Hospitals performed best on the Core Index. Given recent policy and programmatic initiatives, we anticipate continued improvement across all indices.
Conclusion: Ongoing index tracking can inform policy impact evaluations and highlight persistent interoperability disparities across hospitals.
期刊介绍：
JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
