HIE not 'causally related' to cost improvements, care quality benefits

An examination of health information exchange research published this month in Health Affairs determines that despite an increase in the sharing of health data across organizations, benefits on costs and care quality are scarce.

For the study, the researchers--from the University of Alabama at Birmingham, Weill Cornell Medical College in New York and Indiana University--analyzed 27 articles that included 94 individual analyses. For each discrete analysis, the researchers then determined whether or not a beneficial relationship existed between the exchange of health data and the outcomes.

Overall, 54 analyses found beneficial effects of health information exchange. However, the researchers argued, of six studies that used designs with strong internal validity--those "capable of identifying causal relationships"--only two found beneficial results.

"Despite the abundance of observational studies finding a beneficial relationship between HIE and outcomes, there is currently no strong evidence to suggest that HIE is causally related to any widespread generalizable benefits," the authors said.

The authors submitted that most of the studies they examined focused on "first-generation" iterations of health information exchange systems, as well as on institutions where active HIE usage was low. Continued meaningful use of such systems, they added, could likely enable better evaluation adoption.

The researchers also called studying the benefits of HIE "extremely challenging in real-world situations where randomized control trials are frequently not feasible." They also theorized that, given the "scarcity" of such studies, the benefits of HIE may have been over- or underestimated in real-world settings.

A report published last month by Black Book Research estimated that the U.S. remains at least 10 years away from achieving ubiquitous secure and robust exchange of patient data. It pointed out that 94 percent of America's providers, healthcare agencies, patients and payers remain without meaningful connections, and added that providers are dropping HIE as a priority.

Earlier in February, the U.S. Department of Health and Human Services announced federal funding efforts aimed at advancing the adoption and use of interoperable health IT tools and services to support health information exchange.

To learn more:
- here's the Health Affairs abstract

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