Appl Clin Inform 2011; 02(04): 499-507
DOI: 10.4338/ACI-2011-05-R-0027
Review
Schattauer GmbH

The Impact of Health Information Exchange on Health Outcomes

A. Hincapie
1   The University of Arizona College of Pharmacy, Tucson, AZ
,
T. Warholak
2   The University of Arizona College of Pharmacy, Tucson, AZ
› Author Affiliations
Further Information

Correspondence to:

Ana L. Hincapie, MS
Graduate Assistant
University of Arizona College of Pharmacy
1295 N Martin
P.O. Box 210202
Tucson, AZ 85721

Publication History

received: 05 May 2011

accepted: 15 October 2011

Publication Date:
16 December 2017 (online)

 

Summary

Background and Objective: Healthcare professionals, industry and policy makers have identified Health Information Exchange (HIE) as a solution to improve patient safety and overall quality of care. The potential benefits of HIE on healthcare have fostered its implementation and adoption in the United States. However,there is a dearth of publications that demonstrate HIE effectiveness. The purpose of this review was to identify and describe evidence of HIE impact on healthcare outcomes.

Methods: A database search was conducted. The inclusion criteria included original investigations in English that focused on a HIE outcome evaluation. Two independent investigators reviewed the articles. A qualitative coding approach was used to analyze the data.

Results: Out of 207 abstracts retrieved, five articles met the inclusion criteria. Of these, 3 were randomized controlled trials, 1 involved retrospective review of data, and 1 was a prospective study. We found that HIE benefits on healthcare outcomes are still sparsely evaluated, and that among the measurements used to evaluate HIE healthcare utilization is the most widely used.

Conclusions: Outcomes evaluation is required to give healthcare providers and policy-makers evidence to incorporate in decision-making processes. This review showed a dearth of HIE outcomes data in the published peer reviewed literature so more research in this area is needed. Future HIE evaluations with different levels of interoperability should incorporate a framework that allows a detailed examination of HIE outcomes that are likely to positively affect care.


#

 


#

Conflict of interest

The authors declare that they have no conflicts of interest in the research. This study was funded by the Centers for Medicare and Medicaid (CMS) Grant Number 0705AZTRA1 provided to Arizona for the Medicaid Health Information Exchange and Utility Project.

  • References

  • 1 Balfour 3rd D, Evans S, Januska J, Lee H, Lewis S, Nolan S. et al. Health information technology –results from a roundtable discussion. Journal of managed care pharmacy 2009; 15 (1 Suppl A) 10.
  • 2 Kern LM, Barron Y, Abramson EL, Patel V, Kaushal R. HEAL NY: Promoting interoperable health information technology in New York State. Health Affairs 2009; 28 (02) 493.
  • 3 Services USDoHaH.. HHS announces additional $162 million in recovery act investment to advance widespread meaningful use of health IT. [cited 2010]; Available from: http://www.hhs.gov/news/press/ 2010pres/03/20100315a.html.
  • 4 Wilt D, Muthig B. Crossing barriers: EMR implementation across a nationwide continuum of care. Journal of healthcare information management 2008; 22 (02) 23.
  • 5 Marchibroda JM. The impact of health information technology on collaborative chronic care management. Journal of managed care pharmacy 2008; 14 (02) S3-S11.
  • 6 Shapiro JS, Kannry J, Lipton M, Goldberg E, Conocenti P, Stuard S. et al. Approaches to patient health information exchange and their impact on emergency medicine. Annals of Emergency Medicine 2006; 48 (04) 426-342.
  • 7 Hripcsak G, Kaushal R, Johnson KB, Ash JS, Bates DW, Block R. et al. The United Hospital Fund meeting on evaluating health information exchange. Journal of biomedical informatics 2007; 40 (06) S3-S10.
  • 8 Goroll AH, Simon SR, Tripathi M, Ascenzo C, Bates DW. Community-wide implementation of health information technology: the Massachusetts eHealth Collaborative experience. Journal of the American Medical Informatics Association 2009; 16 (01) 132.
  • 9 Solomon MR. Regional health information organizations: a vehicle for transforming health care delivery?. Journal of medical systems 2007; 31 (01) 35-47.
  • 10 Adler-Milstein J, Landefeld J, Jha AK. Characteristics associated with regional health information organization viability. Journal of the American Medical Informatics Association 2010; 17 (01) 61.
  • 11 Adler-Milstein J, Bates DW, Jha AK. US Regional health information organizations: progress and challenges. Health Affairs 2009; 28 (02) 483.
  • 12 Shapiro J, Kannry J, Kushniruk A. New York Clinical Information Exchange (NYCLIX) Clinical Advisory Subcommittee. Emergency physicians’ perceptions of health information exchange. J Am Med Inform Assoc 2007; 14: 700-705.
  • 13 Shapiro JS. Evaluating public health uses of health information exchange. Journal of biomedical informatics 2007; 40 (06) S46-S49.
  • 14 Richards L. Handling qualitative data: A practical guide. Sage Publications Ltd; 2009
  • 15 Overhage JM, Dexter PR, Perkins SM, Cordell WH, McGoff J, McGrath R. et al. A randomized, controlled trial of clinical information shared from another institution. Annals of emergency medicine 2002; 39 (01) 14-23.
  • 16 Lang E, Afilalo M, Vandal AC, Boivin JF, Xue X, Colacone A. et al. Impact of an electronic link between the emergency department and family physicians: a randomized controlled trial. CMAJ : Canadian Medical Association journal = journal de l‘Association medicale canadienne 2006; 174 (03) 313-318.
  • 17 Brebner JA, Brebner EM, Ruddick-Bracken H. Accident and emergency teleconsultation for primary care –a systematic review of technical feasibility, clinical effectiveness, cost effectiveness and level of local management. J Telemed Telecare 2006; 12 (01) 5-8.
  • 18 Vest JR. Health information exchange and healthcare utilization. Journal of medical systems 2009; 33 (03) 223-231.
  • 19 Branger PJ, van‘t Hooft A, van der Wouden JC, Moorman PW, van Bemmel JH. Shared care for diabetes: supporting communication between primary and secondary care. International journal of medical informatics 1999; 53 (2–3) 133-142.
  • 20 Hansagi H, Olsson M, Hussain A, Öhlén G. Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users?. European Journal of Emergency Medicine 2008; 15 (01) 34.
  • 21 Kuperman GJ. Health-information exchange: why are we doing it, and what are we doing?. J Am Med Inform Assoc 2011; 18 (05) 678-682.
  • 22 Rudin RS. Why clinicians use or don‘t use health information exchange. J Am Med Inform Assoc 2011; 18 (04) 529.
  • 23 Vest JR, Gamm LD, Ohsfeldt RL, Zhao H, Jasperson J. Factors Associated with Health Information Exchange System Usage in a Safety-Net Ambulatory Care Clinic Setting. Journal of Medical Systems Published online (Epub ahead of print). Available at: http://dx.doi.org/10.1007/s10916–011–9712–3.
  • 24 Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E. et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine 2006; 144 (10) 742.
  • 25 Waneka R, Spetz J. Hospital Information Technology Systems’ Impact on Nurses and Nursing Care. Journal of Nursing Administration 2010; 40 (12) 509.
  • 26 Govindan M, Van Citters AD, Nelson EC, Kelly-Cummings J, Suresh G. Automated detection of harm in healthcare with information technology: a systematic review. Quality and Safety in Health Care 2010; 19 (05) 1.
  • 27 Gallego AI, Gagnon MP, Desmartis M. Assessing the Cost of Electronic Health Records: A Review of Cost Indicators. Telemedicine and e-Health 2010; 16 (09) 963-972.
  • 28 Menachemi N, Chukmaitov A, Saunders C, Brooks RG. Hospital quality of care: Does information technology matter? The relationship between information technology adoption and quality of care. Health Care Management Review 2008; 33 (01) 51.
  • 29 Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. The Journal of the American Board of Family Medicine 2010; 23 (05) 655.
  • 30 Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D. et al. Framework for design and evaluation of complex interventions to improve health. Bmj 2000; 321 (7262) 694.
  • 31 Ammenwerth E, Gräber S, Herrmann G, Bürkle T, König J. Evaluation of health information systems--problems and challenges. International Journal of Medical Informatics 2003; 71 (2–3) 125-135.

Correspondence to:

Ana L. Hincapie, MS
Graduate Assistant
University of Arizona College of Pharmacy
1295 N Martin
P.O. Box 210202
Tucson, AZ 85721

  • References

  • 1 Balfour 3rd D, Evans S, Januska J, Lee H, Lewis S, Nolan S. et al. Health information technology –results from a roundtable discussion. Journal of managed care pharmacy 2009; 15 (1 Suppl A) 10.
  • 2 Kern LM, Barron Y, Abramson EL, Patel V, Kaushal R. HEAL NY: Promoting interoperable health information technology in New York State. Health Affairs 2009; 28 (02) 493.
  • 3 Services USDoHaH.. HHS announces additional $162 million in recovery act investment to advance widespread meaningful use of health IT. [cited 2010]; Available from: http://www.hhs.gov/news/press/ 2010pres/03/20100315a.html.
  • 4 Wilt D, Muthig B. Crossing barriers: EMR implementation across a nationwide continuum of care. Journal of healthcare information management 2008; 22 (02) 23.
  • 5 Marchibroda JM. The impact of health information technology on collaborative chronic care management. Journal of managed care pharmacy 2008; 14 (02) S3-S11.
  • 6 Shapiro JS, Kannry J, Lipton M, Goldberg E, Conocenti P, Stuard S. et al. Approaches to patient health information exchange and their impact on emergency medicine. Annals of Emergency Medicine 2006; 48 (04) 426-342.
  • 7 Hripcsak G, Kaushal R, Johnson KB, Ash JS, Bates DW, Block R. et al. The United Hospital Fund meeting on evaluating health information exchange. Journal of biomedical informatics 2007; 40 (06) S3-S10.
  • 8 Goroll AH, Simon SR, Tripathi M, Ascenzo C, Bates DW. Community-wide implementation of health information technology: the Massachusetts eHealth Collaborative experience. Journal of the American Medical Informatics Association 2009; 16 (01) 132.
  • 9 Solomon MR. Regional health information organizations: a vehicle for transforming health care delivery?. Journal of medical systems 2007; 31 (01) 35-47.
  • 10 Adler-Milstein J, Landefeld J, Jha AK. Characteristics associated with regional health information organization viability. Journal of the American Medical Informatics Association 2010; 17 (01) 61.
  • 11 Adler-Milstein J, Bates DW, Jha AK. US Regional health information organizations: progress and challenges. Health Affairs 2009; 28 (02) 483.
  • 12 Shapiro J, Kannry J, Kushniruk A. New York Clinical Information Exchange (NYCLIX) Clinical Advisory Subcommittee. Emergency physicians’ perceptions of health information exchange. J Am Med Inform Assoc 2007; 14: 700-705.
  • 13 Shapiro JS. Evaluating public health uses of health information exchange. Journal of biomedical informatics 2007; 40 (06) S46-S49.
  • 14 Richards L. Handling qualitative data: A practical guide. Sage Publications Ltd; 2009
  • 15 Overhage JM, Dexter PR, Perkins SM, Cordell WH, McGoff J, McGrath R. et al. A randomized, controlled trial of clinical information shared from another institution. Annals of emergency medicine 2002; 39 (01) 14-23.
  • 16 Lang E, Afilalo M, Vandal AC, Boivin JF, Xue X, Colacone A. et al. Impact of an electronic link between the emergency department and family physicians: a randomized controlled trial. CMAJ : Canadian Medical Association journal = journal de l‘Association medicale canadienne 2006; 174 (03) 313-318.
  • 17 Brebner JA, Brebner EM, Ruddick-Bracken H. Accident and emergency teleconsultation for primary care –a systematic review of technical feasibility, clinical effectiveness, cost effectiveness and level of local management. J Telemed Telecare 2006; 12 (01) 5-8.
  • 18 Vest JR. Health information exchange and healthcare utilization. Journal of medical systems 2009; 33 (03) 223-231.
  • 19 Branger PJ, van‘t Hooft A, van der Wouden JC, Moorman PW, van Bemmel JH. Shared care for diabetes: supporting communication between primary and secondary care. International journal of medical informatics 1999; 53 (2–3) 133-142.
  • 20 Hansagi H, Olsson M, Hussain A, Öhlén G. Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users?. European Journal of Emergency Medicine 2008; 15 (01) 34.
  • 21 Kuperman GJ. Health-information exchange: why are we doing it, and what are we doing?. J Am Med Inform Assoc 2011; 18 (05) 678-682.
  • 22 Rudin RS. Why clinicians use or don‘t use health information exchange. J Am Med Inform Assoc 2011; 18 (04) 529.
  • 23 Vest JR, Gamm LD, Ohsfeldt RL, Zhao H, Jasperson J. Factors Associated with Health Information Exchange System Usage in a Safety-Net Ambulatory Care Clinic Setting. Journal of Medical Systems Published online (Epub ahead of print). Available at: http://dx.doi.org/10.1007/s10916–011–9712–3.
  • 24 Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E. et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine 2006; 144 (10) 742.
  • 25 Waneka R, Spetz J. Hospital Information Technology Systems’ Impact on Nurses and Nursing Care. Journal of Nursing Administration 2010; 40 (12) 509.
  • 26 Govindan M, Van Citters AD, Nelson EC, Kelly-Cummings J, Suresh G. Automated detection of harm in healthcare with information technology: a systematic review. Quality and Safety in Health Care 2010; 19 (05) 1.
  • 27 Gallego AI, Gagnon MP, Desmartis M. Assessing the Cost of Electronic Health Records: A Review of Cost Indicators. Telemedicine and e-Health 2010; 16 (09) 963-972.
  • 28 Menachemi N, Chukmaitov A, Saunders C, Brooks RG. Hospital quality of care: Does information technology matter? The relationship between information technology adoption and quality of care. Health Care Management Review 2008; 33 (01) 51.
  • 29 Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. The Journal of the American Board of Family Medicine 2010; 23 (05) 655.
  • 30 Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D. et al. Framework for design and evaluation of complex interventions to improve health. Bmj 2000; 321 (7262) 694.
  • 31 Ammenwerth E, Gräber S, Herrmann G, Bürkle T, König J. Evaluation of health information systems--problems and challenges. International Journal of Medical Informatics 2003; 71 (2–3) 125-135.