Implementation of Health Information Exchange (HIE) at the Pima County Adult Detention Complex (PCADC): Lessons Learned

Abstract

Objectives: To evaluate the successes and failures of the recent implementation of the Arizona Health-e Connection (AzHeC) health information exchange (HIE) at the Pima County Adult Detention Center (PCADC); to identify a generalized infrastructure and draft recommendations for implementing HIE at other correctional facilities. Methods: Participants pertinent to the implementation by current staff at the PCADC were identified through snowball sampling. Interviews were conducted in-person or by telephone using a semi-structured interview guide. Demographics regarding roles and responsibilities during implementation were collected during each interview. Participants were asked for input regarding key aspects and lessons learned from the implementation. Interviews were audio-recorded, transcribed verbatim, and then analyzed with Atlas.ti software for common themes. Results: A total of 12 individuals were interviewed, providing a comprehensive set of perspectives. Six common themes were identified: impact of being a novel implementer; challenges surrounding implementation; problems during implementation; what was done well; benefits of the system; and communication during implementation. Potential barriers that were successfully anticipated were establishing the value of the HIE through pilot studies to obtain early stakeholder buy-in, and addressing legal/privacy issues for the at-risk population in the corrections system. Problems that arose during implementation often involved information technology issues. Conclusions: Despite challenges faced throughout the HIE implementation, improvements in patient care, workflow, and time-savings made a tremendous impact for those involved. The lessons learned and advice given by the participants of this study can provide guidance for other correctional health systems wishing to implement a HIE at their facility.