More reviews are needed on benefits and impacts of health information exchange (HIE), according to researchers who found that clinical outcomes and harms of info sharing are not fully studied.
The researchers, from Oregon Health & Science University, the Seattle-based University of Washington and the Veteran's Affairs Maine Healthcare System, examined 34 studies on outcomes of HIE.
However, the studies were very limited. They did not report on primary clinical outcomes, such as mortality and morbidity, nor did they identify potential issues caused by HIE, according to an article published in the Journal of Medical Internet Research: Medical Informatics.
The most common studies, they found, were "retrospective cohorts" with HIE use focused on a specific outcome, as well as surveys that focused on perceived outcomes.
In addition, "none of the studies analyzed individual episodes of care to determine clinical appropriateness of possible changes brought about by HIE use," the report's authors said. They also called the evidence "low-quality" because the studies largely are retrospective and asked limited questions.
To gain a better understanding of the impacts of HIEs, studies will need to ask comprehensive questions, have more rigorous design and "be part of a coordinated, systematic approach to studying HIE," the researchers concluded.
While the use of HIE is increasing, overall adoption remains "low," according to a report released this week by the Agency for Healthcare Research and Quality.
However, that report also 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.
HIE use also is not without it barriers, according to a recent review of the Beacon Community Program. It found that the time it takes for programs to show a real impact on cost, quality and outcomes "is not trivial." In addition, even communities that already have advanced EHRs and HIE readiness needed "significant time" for real progress to be made.
To learn more:
- here's the study