Survey: Docs name interoperability, infrastructure barriers to HIE
Health information exchanges (HIEs) offer opportunities to improve care and reduce healthcare costs but there are significant barriers to participation, according to a survey of 527 physicians conducted by Doctors Helping Doctors Transform Health Care.
Among to the doctors surveyed, the top benefits expected from HIEs were:
- Improvements in quality of care (cited by 80 percent of doctors);
- Better ability for doctors to coordinate care (80 percent);
- The ability to meet the demands of new models, such as accountable care (78 percent);
- Easier reporting to third-party agencies (72 percent);
- Opportunities to qualify for incentive programs (72 percent);
- Greater efficiency in practice settings (69 percet); and
- Lower healthcare costs (57 percent).
Despite the benefits of HIEs, survey respondents expressed several concerns. When asked about the obstacles keeping them from participating in exchanges, doctors' replies included the following:
- Lack of interoperability between various EHR systems (cited as a major barrier by 71 percent of respondents);
- Lack of infrastructure to support an HIE (71 percent); and
- The costs of setting up and maintaining interfaces and exchanges (68 percent).
Minor barriers cited included privacy and security concerns, worries about malpractice liability if information isn’t acted on, and concerns about not being able to trust data in the exchange.
Also, the impact of an HIE depends a lot on the types of information the exchange allows to be shared. When participating in an information exchange, doctors said the most important pieces of information to receive during transitions of care are:
- Medication lists;
- Relevant lab and imaging test results;
- Discharge summaries;
- Reasons for referral; and
- Treatment summaries and changes recommended by a consulting physician.
Survey respondents also said it was important to get that information in a timely manner, with 80 percent saying a reasonable time frame would be either “immediately” or “within 24 hours,” when a patient is being treated for an urgent problem. With non-urgent issues, 70 percent said they would want information within three business days.