Health Scholars

Eskenazi Health Scholars Program

Eskenazi Hospital buildingThe federal Agency for Healthcare Research and Quality recently awarded a large grant to Joshua Vest, PhD, Associate Professor of Health Policy and Management and Director of the Center for Health Policy, to study the use and effectiveness of alternative methods of electronically sharing information in primary care settings. This will be the first study of its kind.

The United States has invested billions on interoperable health information technologies, but there is very little evidence of health information exchange's effects on utilization and on how it is used in primary care practice, said Vest.

According to Vest, providers have access to two different health information exchange approaches to meet their information needs.

One approach is referred to as "pull," which allows providers to query communitywide, longitudinal patient records. A second approach is "push," where key information, such as test results, is automatically delivered to providers.

There is a lack of evidence of the effectiveness of either the "push" or "pull" approach, Vest said. "Furthermore, which approach to sharing information best fits into primary care is unknown," he said.

One objective of the study is to determine whether primary care providers use "push" and "pull" as complementary or alternative approaches to health information exchange, Vest said. The study will leverage a novel data set of individual provider and staff behavior tracked within an electronic health record system, combined with detailed measures of "push" and "pull" health information exchange usage.

"These data furnish a complete, detailed temporal sequence of providers' behavior, revealing how each approach to health information exchange is used during a patient visit," Vest said.

The study will also quantify the effect of "push" and "pull" health information exchange on potentially avoidable health care utilization, he said.

The Center for Health Policy works closely with local health systems and Indiana state agencies to address the health issues in our state and beyond.