Although more than half of hospitals were sharing information with providers outside of their organizational affiliations as of 2012, only some were exchanging clinical care summaries and medication lists, according to a study by researchers at the Office of the National Coordinator.
Hospitals’ health information exchange, either through EMR interoperability and health information organizations, has increased 41 percent since 2008, and sharing of all types of clinical information increased between 39 percent and 55 percent, the ONC’s director of economic analysis and modeling, Michael Furukawa, and colleagues reported in Health Affairs.
More than half of hospitals were exchanging radiology and laboratory reports, too, Furukawa and colleagues found. But only only about one-third of the hospitals were e
And another finding that the ONC will be watching in future years, hoping the number grows: only 36 percent of hospitals were exchanging information with other hospitals outside of their affiliation, despite the 51 percent of hospitals that were sharing clinical information with unaffiliated ambulatory care providers.
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Following the HITECH Act’s $540 million investment in state HIE initiatives and the start of the Meaningful Use program, hospital adoption of EMR systems and participation in health information exchange organizations grew “significantly” after 2008, Furukawa wrote in the study. As of 2012, 44 percent of hospitals were using at least a basic EMR, compared to 9 percent in 2008, and almost 30 percent were participating in a regional HIO, compared to 16 percent in 2008.
Almost 85 percent of those hospitals that had adopted an EMR as of 2012 and were participating in an HIO exchanged information with providers outside their affiliations, compared to 71 percent of hospitals using an HIO without an EMR and 60 percent of hospitals and 60 percent of hospitals with an EMR but not HIO membership.
“Despite substantial growth in EHR adoption and the availability of regional HIOs, exchange activity has been relatively limited in hospital settings,” Furukawa wrote. “In general, limited interoperability across vendors, low motivation to share information in a fee-for-service payment environment, and the high cost of interfaces remain substantial barriers to widespread health information sharing. In many cases, hospitals lack the means to share patient information electronically with other hospitals or p
The study used data from national surveys of hospitals conducted between 2008 and 2012 to follow health information exchange trends — and another significant finding was that 71 percent of hospitals surveyed had plans to invest in some form of digital HIE, either through HIOs or EMR interfacing.
The study also found some correlations between EMR adoption, HIO participation and hospital HIE practices.
A hospital’s HIO participation was more closely associated with sharing laboratory and radiology reports than with exchanging clinical care summaries and medication lists. That may due to “established standards and progress in developing interfaces by leading vendors,” Furukawa wrote.
“The fact that hospitals with HIO participation — either alone or together with EHR systems — were more likely than other hospitals to exchange information with other providers may in part reflect demand for the capability of looking up patient data in the context of unplanned care when no data are available at the site of care, as in the case of an emergency department visit,” Furukawa wrote.
A hospital’s EMR adoption, meanwhile, correlated more closely with the exchange of care summaries than any other type of clinical information, suggesting to Furukawa that EMRs “may be well suited” for exchange with other known providers to coordinate care.
“EHR systems and HIOs in combination may thus complement each other to improve information sharing overall, across the spectrum of clinical encounters,” Furukawa wrote. source
