All ETDs from UAB

Advisory Committee Chair

Sue S Feldman

Advisory Committee Members

Darrell Burke

Allyson G Hall

Nataliya V Ivankova

Brian Yeaman

Document Type

Dissertation

Date of Award

2019

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Behavioral health disorders are common, and they frequently co-occur with chronic physical illnesses. Behavioral health patients with chronic physical illnesses are three times more likely to be readmitted to the hospital within 30 days of discharge than non-behavioral health patients. Readmissions among behavioral health patients are costly: $817 million in readmissions costs are related to mood and psychiatric disorders. High readmission rates are attributed, in part, to poor exchange of health-related information between various care providers. Health information exchanges (HIEs) are effective in chronic disease management, but their effectiveness in integrated care delivery is unclear. This study examined facilitators of and barriers to obtaining behavioral health information from HIEs. The study employed a sequential explanatory mixed methods design: the initial quantitative phase of the study used a validated survey instrument to examine enabling and impeding factors for obtaining behavioral health information from an HIE. The surveys were administered to healthcare providers in Alabama and Oklahoma via email. The subsequent qualitative phase explored the identified facilitators and barriers in greater depth and revealed other potential factors that affect the acquisition and use of behavioral health data from an HIE. Semi-structured interviews were conducted with a subsample of survey respondents to allow participants to elaborate on factors identified from the survey. This study: 1) helped to gain an understanding of the challenges and benefits of integrating care, particularly for patients with behavioral health disorders; 2) examined the role of health IT in integrated care delivery; and 3) examined healthcare providers’ perspectives about using technology to integrate care.

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