Study: Few HIEs Have Been Evaluated; Benefits Difficult To Determine

December 2, 2014 in News

A lack of data and evaluations of the more than 100 health information exchanges operating across the U.S. makes it difficult to assess their benefits, according to a RAND Corporation study published in the Annals of Internal Medicine, Forbes reports (Japsen, Forbes, 12/1).

Study Details, Findings

The study, funded by the Department of Veterans Affairs, was conducted between January 2003 and May 2014 (Durben Hirsch, FierceEMR, 12/1). The researchers attempted to review the databases for each HIE during that time period.

Overall, the researchers found that only 13 HIEs had been evaluated and had data available on how much providers used them, six of which were in New York (Gold, Politico Pro, 12/1).

Further, the study showed that those 13 HIEs were used in only 2% to 10% of patient encounters (FierceEMR, 12/1).

The researchers found evidence that HIEs could reduce emergency department use and costs. However, other long-term effects are unknown because of the lack of data.

Robert Rudin, a co-author of the report, said that “[w]ithout an evaluation, it is difficult to draw conclusions.”

According to the study, barriers to expanding the use of HIEs include issues with:

  • Cost;
  • Privacy;
  • Technology; and
  • Workflow (Politico Pro, 12/1).

The researchers argued that the low use makes it difficult for HIEs to justify themselves from a business standpoint (FierceEMR, 12/1). However, the researchers noted that “[e]merging payment models, such as accountable care organizations, bundled payments and other risk-sharing payment arrangements, may help to create a greater value proposition” (Politico Pro, 12/1).

Rudin suggested that all HIEs develop “evaluation plan[s].” He said, “That might mean partnering with an external research organization and having a more formal evaluation to see the extent of use and the impact on patient health outcomes and quality” (Forbes, 12/1).

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