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HIE on the rise, new government study shows

Health information exchange (HIE) has accelerated, particularly in hospitals, according to a new report from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ).

However, the report also shows that HIE use is still low overall, with ambulatory healthcare providers and nursing homes showing little adoption, and that HIE’s effects on medical outcomes still need more research.

Three investigators and a research librarian based at the Pacific Northwest Evidence-based Practice Center in Oregon produced the report under contract with AHRQ after reviewing and analyzing about 200 full-text studies and articles focusing on various aspects of HIE.

The materials included 34 pieces on effectiveness; 26 on intermediate clinical, economic, or patient outcomes; eight that reported on clinical perceptions of HIE; 58 studies on HIE use;  22 on usability; 45 on facilitators or barriers to HIE implementation; and 17 on factors related to sustainability of HIE.

Studies of HIE use found that adoption of HIE has risen sharply in recent years, with 76% of U.S. hospitals exchanging information electronically in 2014, an 85% increase over 2008 and a 23% increase since 2013.

On the other hand, as of 2012, only 38% of office-based physicians used HIE systems and less than 1% of long-term care providers are using electronic health information exchange, according to the report.

Among organizations with HIE capabilities, few employees actually used HIE often, the AHRQ study revealed.

The report’s authors concluded that barriers to wider use of HIE include:

  • Lack of critical mass participating in the exchange
  • Inefficient workflow
  • Poorly designed interface and update features.

They also said the HIE field needs more studies. However, the study’s basic premise is that HIE is a good thing.

“The idea that records should follow patients wherever they receive care has been promoted as a cornerstone of efforts to improve the coordination, efficiency and effectiveness of health services,” according to the executive summary. “The underlying belief is that ultimately patients would benefit if all relevant information were available to the various healthcare providers involved in treating them and working to maintain their health.”