Unintentional poisoning is the second leading cause of injury death in the United States. Collaboration between poison control centers (PCCs) and emergency departments (EDs) is dependent upon verbal, telephone communication that can lead to miscommunication, data loss, and error. (3, 4). Recent research has identified numerous vulnerabilities and inefficiencies in the current telephone-based system of collaboration, vulnerabilities that must be addressed in order to ensure patient safety. Health information exchange (HIE), the electronic exchange of patient information, could better support PCC-ED collaboration for poisoned patients during routine operations and in disaster scenarios, when telephone-based communication is fragile. However, we currently lack both process models and informatics tools (standards and software) for PCC-ED health information exchange and this poses a substantial barrier to HIE for U.S. poison control centers operating with limited resources. Moreover, there is no available information on the clinical effects of implementing this type of provider-to-provider health information exchange, including effects on workflow and patient care.
The specific aims of this study are as follows: (1) Develop a model process for HIE supported ED- PCC collaboration, (2) Develop and implement informatics tools for HIE supported ED-PCC collaboration, and (3) Evaluate the effects of the model HIE process and informatics tools on workflow, communication, efficiency, and utilization. We will develop a replicable, scalable process for ED-PCC health information exchange and develop informatics tools that enable emergency departments and poison control centers to engage in HIE. We will also evaluate the effect of the prototype information exchange process on workflow and clinical outcomes including emergency department door-to-decision time, time to PCC case closure, and change in the number of telephone calls exchanged between EDs and PCCs. These innovations reflect patient-focused information management and are designed to ensure availability of poisoning-related information to support transitions and collaborations in care. !

Public Health Relevance

Poisonings are a leading cause of unintentional injury death in the United States. We will develop and evaluate a replicable, standards-based approach to health information exchange between emergency departments and poison control centers. Health information exchange has potential to strengthen continuity of care for poisoned patients, and improve communication and collaboration between emergency departments and poison control centers during disaster scenarios.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Project (R01)
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Health Care Technology and Decision Science (HTDS)
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Randhawa, Gurvaneet
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University of Utah
Schools of Nursing
Salt Lake City
United States
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Khalifa, Aly; Del Fiol, Guilherme; Cummins, Mollie R (2016) Public Health Data for Individual Patient Care: Mapping Poison Control Center Data to the C-CDA Consultation Note. AMIA Annu Symp Proc 2016:1850-1859
Nelson, Scott D; Del Fiol, Guilherme; Hanseler, Haley et al. (2016) Software Prototyping: A Case Report of Refining User Requirements for a Health Information Exchange Dashboard. Appl Clin Inform 7:22-32
Del Fiol, Guilherme; Crouch, Barbara Insley; Cummins, Mollie R (2015) Data standards to support health information exchange between poison control centers and emergency departments. J Am Med Inform Assoc 22:519-28
Cummins, Mollie R (2014) Nursing informatics and learning health system. Comput Inform Nurs 32:471-4