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By Cynthia Corzo
Barriers limiting U.S. hospitals' use of Health Information Exchange (HIE) methods for sending information to external providers could hinder progress in interoperability and compromise patient safety, FIU Business research finds.
Published in the International Journal of Medical Informatics in September 2023, the research found that many exchanges involving intermediaries – such as health information service providers, electronic health record (EHR) vendor-based networks and national networks – are more often utilized than one-to-one exchange methods like provider portals and direct access to EHR by login credentials.
The results highlight a considerable gap between hospitals adopting these transmission methods and actively using them.
"This gap has implications for healthcare quality, efficiency and patient outcomes," said Pouyan Esmaeil Zadeh, associate professor of information systems and business analytics at FIU Business and one of the researchers. "Understanding these barriers is crucial for developing effective strategies to improve HIE usage."
The researchers examined data from 3,015 community hospitals that reported their methods of sending patient health information in the 2019 American Hospital Association Information Technology Supplement Survey.
Adoption alone does not guarantee utility.
"Businesses must also focus on training, change management and overcoming barriers to fully realize the benefits of technology investments," said Min Chen, associate professor of information systems and business analytics at FIU Business, who led the research. "The distinction between adoption and usage is crucial for understanding why, despite significant investments in health IT infrastructure, expected benefits in terms of interoperability and efficient healthcare delivery are not always realized."
The study's findings underscore the need for ongoing assessment and adaptation of technology strategies, Chen added. This makes them timely given the recent Department of Health and Human Services final rule under the 21st Century Cures Act, which penalizes healthcare providers for blocking electronic health information.
Lessons from the research will allow healthcare organizations and hospitals to better plan and implement new technologies, ensuring effective ongoing use. Targeted interventions, noted Zadeh, can improve HIE usage and deliver positive results.
"Patients can receive better care coordination, reduced medical errors and improved health outcomes while healthcare providers, with more effective information sharing, can improve decision-making and efficiency," he said. "Better HIE usage can reduce duplicate tests and procedures, lowering costs for healthcare systems; and understanding barriers to HIE usage can inform more effective health IT policies."
