Adler-Milstein: Hospitals slow to adopt health information exchanges

A study published by UMSI Assistant Professor Julia Adler-Milstein and co-author Ashish K. Jha of Harvard University finds that the majority of hospitals still do not engage in the electronic exchange of health information. This is despite strong federal policies designed to encourage these exchanges and a substantial investment in health information technology.

“Health information exchange among U.S. hospitals: who’s in, who’s out, and why?” appears in the current issue of the quarterly publication Healthcare, the Journal of Delivery Science and Innovation.

A key goal of the 2009 HITECH Act is to ensure broad electronic exchange of clinical data among providers. The study sought to assess whether current policy efforts, many of which are being developed by states, appear to be tackling the key barriers to hospital participation in health information exchange (HIE).

The researchers found that only 30% of U.S. hospitals engaged in health information exchange with unaffiliated providers. There was large variation in state-level participation, with some states achieving more than 70% participation (Rhode Island, Delaware and Vermont) and others with minimal participation. In markets where exchange occurred, for-profit hospitals were far less likely to engage in HIE than non-profit hospitals. Hospitals with a larger market share were more likely to engage in exchange, as were hospitals in less competitive markets.

Their conclusion is that despite an uptick in hospital HIE participation since the start of HITECH, the majority of hospitals still do not engage in HIE and there is large state-to-state variation. Specific types of hospitals appear to feel that they are better off not engaging in HIE.

Stronger policies and incentives may be necessary to convince organizations to share their data electronically. The authors state that “Pursuing these is critical to ensuring that the highly anticipated quality and efficiency gains from our large national investment in health information technology are realized.”

The full paper is available online.

Posted on June 23, 2014