Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

TLDR

Electronic health information exchange, enabled by expanding regional health information organizations and widespread EHR adoption, can improve care coordination, yet the extent of hospital exchange activity in the United States was previously unclear and may be accelerated by emerging policy initiatives and payment reforms. National surveys show that from 2008 to 2012 hospital electronic exchange with external providers rose 41 %, reaching nearly 60 % of hospitals in 2012, with higher activity linked to EHR adoption and HIO participation, though exchanges of clinical summaries and medication lists outside the organization remained limited.

Abstract

Electronic health information exchange can improve care coordination for patients by enabling more timely and complete sharing of clinical information among providers and hospitals. Approaches to health information exchange have expanded in recent years with the growth in entities such as regional health information organizations (HIOs) and the increased adoption of electronic health record (EHR) systems. However, little is known about the extent of exchange activity in US hospitals. Using national surveys of hospitals, we found that between 2008 and 2012, hospitals' electronic exchange of health information with other providers increased significantly, regardless of provider type, organizational affiliation, or type of clinical information. In 2012 nearly six in ten hospitals actively exchanged electronic health information with providers and hospitals outside their organization, an increase of 41 percent since 2008. EHR adoption and HIO participation were associated with significantly greater hospital exchange activity, but exchanges with providers outside the organization and exchanges of clinical care summaries and medication lists remained limited. New and ongoing policy initiatives and payment reforms may accelerate the electronic exchange of health information by creating new data exchange options, defining standards for interoperability, and creating payment incentives for information sharing across organizational boundaries.