Report: HIEs failing to capture impact on quality of care

Most backers of health information exchanges believe they are improving care and generating a positive return on investment, but few of the exchanges actually offer up data to confirm those beliefs, according to a study published at Perspectives in Health Information Management.

The study is based on data from 35 community HIEs initiated in November 2013, as well as questions posed to people familiar with the exchanges. While two-thirds reported a positive ROI, one-fourth or fewer respondents reported using metrics to calculate ROI. In addition, 76 percent did not deliver reports on quality measures and 73 percent were not using data to measure quality performance of participating providers.

"Our study shows that calculating ROI for HIEs, or their impact on quality of care, remains a secondary priority for most HIEs," the authors state. "These findings, taken in combination with the ending of HITECH funding, raise serious questions about the future sustainability of HIEs, and what form they will take."

Most HIEs range in cost from $1 million to $5 million, the authors say, asking who should foot the bill for a community resource where the impact is not based on measurable proof.

The authors concede that the small sample size might be biased, that it might be too soon for HIEs for to achieve optimal functionality and that new solutions might be needed to address the problems that HIEs were meant to solve.

Charles Christian, vice president of technology and engagement at the Indiana Health Information Exchange, recently told FierceHealthIT that the business of data exchange has a higher fixed cost than you would think, due to maintaining large databases.

According to research published recently in BMC Medical Informatics & Decision Making, HIEs hold the potential to improve clinical data sharing, yet many overlook an essential early step--understanding how clinicians use the information they're requesting.

"By focusing on the drivers of [outside information] requests, HIE designers and administration can work with clinicians to give physicians information they need at a time that it is clinically relevant," the latter study's authors say.

To learn more:
- here's the research

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