Application of the Informatics Stack framework to describe a population-level emergency department return visit...

Area of Science:

• Health Informatics
• Population Health Management
• Information Systems Architecture

Background:

• Population health programs increasingly depend on Health Information Technology (HIT).
• Describing HIT architecture is crucial for evaluating these programs.
• Existing sociotechnical frameworks have limitations in comprehensively describing HIT programs.

Purpose of the Study:

• To apply the novel Informatics Stack framework for a detailed description of the Emergency Department Return Visit Quality Program's (EDRVQP) HIT architecture.
• To identify factors that enable or act as barriers within population health programs utilizing HIT.

Main Methods:

• A qualitative study employing semi-structured interviews with key informants from stakeholder organizations.
• Random selection of emergency departments and purposive sampling for key informants.
• Inductive qualitative analysis using grounded theory, supplemented by a literature review.

Main Results:

• The Informatics Stack successfully detailed the EDRVQP's HIT architecture across multiple levels.
• Key enablers included high electronic health record adoption, legislative mandates, functional data standards, and existing health networks.
• Barriers identified were privacy legislation and high turnaround times.

Conclusions:

• The Informatics Stack offers a robust method for describing HIT architecture in population health programs, facilitating replication.
• The EDRVQP exemplifies the practical application of continuous quality improvement (QI) at a provincial level using HIT.