New Study Concludes Significant Benefits of HIE

In April 2018, a study in the Journal of the American Medical Informatics Association concluded that health information exchange (HIE) has a positive impact on care delivery and reduction of costs.

Previous studies have been done with similar conclusions, but they were primarily in specific communities or states. This nationwide study is unique and a pivotal moment as HIEs are scrutinized for their value.

The study  “The benefits of health information exchange: an updated systematic review” by Nir Menachemi, Saurabh Rahurkar, Christopher A Harle and Joshua R Vest had the stated purpose to “review the recent literature on the impact of HIE.” Researchers identified 24 articles that included 63 individual analyses. Among all analyses, nearly 70% of the studies reported a beneficial effect from health information exchange. See details in figure below.

The study looked at five main areas as follows:

Healthcare Utilization

Of the analyzed studies, 48% included a beneficial effect from health information exchange. “HIE was associated with improved performance on hospital and 30-day readmissions, ICU and ED admissions, repeated imaging, therapeutic medical procedures, and total number of orders,” the authors state. 

Healthcare Costs

“HIE was associated with a reduction of total costs of care, lab test costs, imaging test costs, and overall measures of return on investment,” the study states. Nearly 78% of the analyzed studies found healthcare cost benefits of HIE.

Healthcare Quality

For 90% of the analyzed literature, HIE was associated with “improved medication reconciliation, immunization and health record completeness, a reduction in care disparities and HIV-related quality of care measures.”

Disease Surveillance and Public Health

For 80 percent of the analyzed studies, disease surveillance and public health were positively affected by health information exchange. “Specifically, HIE was linked with improved population level immunization rates, the timeliness of reporting of reportable conditions, identification of drug seeking behaviors, and improved surveillance of high ED utilizing vulnerable patients,” the authors stated.

HIE Type

A common question when evaluating the effectiveness of HIE is the type – whether the HIE is a community-based structure or more of an enterprise-level or vendor HIE. According to this study, “Studies assessing a community HIE were more likely to report a benefit effect compared to studies that examined other types of HIEs. Community HIEs attempt to facilitate information exchange among the widest set of available providers within an area. As a result, community HIEs are positioned to provide access to the broadest range of patient information. In contrast, enterprise HIE or vendor-mediated HIEs have narrower exchange networks and, therefore, may not have access to the range of patient information necessary to address the challenges that result in poor outcomes.”

Source: “The benefits of health information exchange: an updated systematic review” by Nir Menachemi, Saurabh Rahurkar, Christopher A Harle and Joshua R Ves, Journal of the American Medical Informatics Association, April 2018