How to identify a unertl scope
The Information Ecology Framework takes a sociotechnical approach toward understanding interrelationships among people and technology in specific local settings. After completing an extensive open-ended grounded theory analysis of our qualitative ethnographic data, we applied the Information Ecology Framework to provide structure for additional data analyses. During initial fieldwork focused on HIE-related workflow, we observed interorganizational interactions that were evocative of ecology studies. While the setting for our study was a specific HIE technology implementation and a regional publicly funded HIE model, lessons learned relating to the Regional Health Information Ecology are widely applicable to different types of HIE technology at various design and implementation stages.Ī central tenet driving our research is that new analytical approaches are needed to examine the complex relationships involved in and generated by HIE technology projects. Along with this perspective, our research question was how does the structure of a regional health care environment change when health information flows across organizational boundaries with technology support? Our goal in examining information exchange through this perspective was to investigate how technology and the health care system can coevolve to reduce information fragmentation and improve care coordination. We propose a new context-aware perspective, the Regional Health Information Ecology, for examining the complex sociotechnical and organizational structures that emerge with successful implementation of HIE technology. Federal mandates requiring interoperability in health information technology design have improved technological support for data exchange, but limited research has examined the direct impact of HIE on patients, health care providers, and the health care system as a whole. Various approaches to interorganizational HIE have faced challenges due to disparate health information technology, organizational issues, and contextual factors related to workflow and medical specialty. Patients have also shown enthusiasm for this type of health information technology and accept that HIE can improve health care delivery. Technology-supported and federally funded health information exchange (HIE) pilots are beginning to improve access to patient health information across organizational boundaries. Health information technology solutions such as electronic health records can assist in reducing information fragmentation within organizations, but solutions to share information across organizational boundaries are also needed. Care fragmentation impedes coordinated and cohesive health care delivery and creates patient safety risks. The current fragmented structure of health care delivery, however, directs patients to providers at multiple organizations for care, leading to dispersed and fragmented health information and decreased continuity of care. Health care organizations have made significant progress in improving patient safety and moving toward patient-centered care over the last decade. These attributes were viewed as challenging and potentially hazardous to the health care system. Over 10 years ago, the Institute of Medicine identified the health care system of the United States to be “fragmented”, “distributed”, and “complex”.