Study: Most U.S. Hospitals Not Participating in Health Data Exchanges

July 1, 2014 in News

The majority of hospitals in the U.S. do not participate in health information exchanges, and there is substantial variation in participation rates among states, according to a new study published in Healthcare: The Journal of Delivery Science and Innovation, Health Data Management reports.

Details of Study

For the study, researchers at Harvard University and the University of Michigan examined hospitals’ participation in HIEs to evaluate whether current federal and state policy efforts to boost engagement are successfully addressing barriers to participation (Goth, Health Data Management, 6/27).

The researchers used data from the 2010 and 2012 American Hospital Association surveys to measure hospitals’ overall participation in HIEs and how hospital participation varied by state. The researchers then analyzed whether all types of hospitals are pursuing HIE participation, or if there were specific types of hospitals that were not yet engaged.


The researchers found that 30% of hospitals participated in HIE as of late 2012, but that participation varied substantially by state. For example, hospitals’ HIE participation was:

  • 0% to 20% in 23 states;
  • 21% to 40% in 15 states;
  • 41% to 60% in six states;
  • 61% to 80% in five states; and
  • 81% to 100% in one state.

In addition, the study found that:

  • 37% of not-for-profit hospitals participated in an HIE, compared with 21% of public hospitals and 8% of for-profit hospitals;
  • 49% of hospitals with the largest market share participated in an HIE, compared with 14% of those with the smallest market share;
  • 49% of large hospitals participated in an HIE, compared with 35% of medium-sized hospitals and 20% of small hospitals; and
  • 46% of hospitals with at least a basic electronic health record system participated in an HIE, compared with 31% of hospitals that did not have basic EHRs (Adler-Milstein/Jha, Healthcare: The Journal of Delivery Science and Innovation, March 2014).


The researchers concluded that stronger policies and incentives are needed to boost hospital participation in HIEs. They wrote, “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” (Leventhal, Healthcare Informatics, 6/30).

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