AHRQ: Despite uptick, HIE use still 'low'

The use of health information exchange (HIE) is increasing, but overall use remains "low," according to a new report from the Agency for Healthcare Research and Quality (AHRQ).

The 465-page report, released this week, reviews 136 studies of HIEs, and finds that more than three-fourths (76 percent) of U.S. hospitals were exchanging information in 2014, a 23 percent increase since 2013. However, only 38 percent of office-based physicians used an HIE in 2013, and use is very low (1 percent) by long-term care providers.

Studies reviewed were somewhat limited in their scope and content, and most were of low quality, according to AHRQ.

Still, the report found that HIEs do have some clinical benefits. They reduced duplicative testing, lowered emergency department costs, improved public health reporting and improved disability claims processing. However, some of the studies were inconsistent, such as whether HIEs had any effect on hospital admissions and re-admissions. Physicians preferred HIEs that pushed data to them rather those HIEs that required them to pull the data out via a query.

Moreover, barriers to their use remained, including the lack of critical mass in exchanging data, inefficient workflow and poorly designed interface and update features. Concerns also were expressed about the sustainability of HIEs.

"Although it may not be the purview of research to decide if HIE should be funded as infrastructure [as with a utility] or as a part of business operations, the notion that HIE should improve efficiency and quality of care, including clinical and economic benefits, is not overwhelmingly supported by the available evidence," the report's authors write. "Positive findings are encouraging, but both the level of the impact and some inconsistencies in results preclude any definitive conclusion." 

AHRQ recommended that studies on HIEs use "more robust designs" and address more "comprehensive questions."

HIEs are gaining ground and evolving over time. They also are exploring different business models and adding services to draw in users and move beyond the Meaningful Use program.

To learn more:
- here's the report (.pdf)