A systematic review of published literature found that the benefits of health information exchanges (HIEs) remain unclear. Of the 27 studies examined, 57 percent of studies reported HIEs were at least somewhat effective in reducing costs or improving outcomes.
However, studies that had randomized controlled designs or other more rigorous methods were more likely to find no benefit for HIEs. Results were recently published in Health Affairs [doi:10.1377/hlthaff.2014.0729].
“A key conclusion of our systematic review is that there is a dearth of rigorous studies that link HIE adoption to clear benefits,” the authors wrote. “Moreover, the scant high-quality evidence that does exist was conducted in disparate settings and evaluated different outcomes.”
The authors noted that the HITECH Act provided financial incentives to providers and funds to states to support HIE activities. HIEs are also viewed as important for accountable care organizations, patient-centered medical homes and bundled payment initiatives.
By 2013, approximately two-thirds of hospitals and half of physician practices had adopted HIEs, an increase from 41 percent and 17 percent in 2008, respectively.
Of the 27 articles that the authors evaluated, 70.4 percent took place in the U.S. and 74.1 percent were published after 2009. In addition, 51.9 percent of the studies used data from emergency departments and 25.9 percent used data from hospitals.
“The current state of the literature does not provide sufficient rigorous evidence for the benefits of HIE,” the authors wrote. “It is incumbent upon future research to increase the use of study designs capable of reducing selection bias and confounding and to include settings, populations, and outcome measures for which little research currently exists. Likewise, government agencies and exchange organizations should support the use of stronger evaluation designs by allocating more resources, including adequate funds, cooperation and access to data. Strong designs with adequate resources will enable researchers to conduct the types of studies that can best inform policy.”
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.