Is the health information exchange landscape as bleak as it appears?
More than $26 billion has been invested, mostly in incentive payments to hospitals and eligible professionals who meaningfully use electronic health records. Yet just a small percentage of healthcare systems are electronically sharing data, according to a report in the latest issue of Health Affairs.
“While the sharing of information electronically -- or health information exchange -- plays a critical role in improving the cost, quality, and patient experience of health care, there is very little electronic information sharing among clinicians, hospitals, and other providers, despite considerable investments in health information technology over the past five years,” Janet Marchibroda, director of the Health Innovation Initiative and the executive director of the CEO Council on Health and Innovation at the Bipartisan Policy Center, wrote in the report.
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Progress has been made in adopting EHR systems within individual healthcare sectors since the HITECH Act in 2009, the report showed. Indeed, the percentage of physicians adopting at least a basic EHR increased from 21.8 percent in 2009 to 48.1 percent in 2013, according to the National Center for Health Statistics. And 44 percent of hospitals have adopted at least a basic EHR, compared to 12.2 percent in 2009, a survey of hospitals published in Health Affairs indicated.
Nonetheless, the level of electronic information sharing across such systems has failed to make solid gains, the report said. The roadblocks slowing information sharing arise from the nature of the healthcare market, in which patient information resides where care and services are delivered, such as the offices of primary care physicians and specialists, hospitals, laboratories, pharmacies, health plans, as well as with the patients.
Individual healthcare sectors showed little inclination to share information with other stakeholders.
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Just 14 percent of doctors surveyed in 2013 were electronically sharing data with providers outside their organizations, according to a different recent study. And a 2012 Health Affairs study showed that 51 percent of hospitals surveyed shared information with ambulatory care providers outside their organizations, while 36 percent shared information with other hospitals. Another report, meanwhile, indicated that only 10 percent of ambulatory practices and 30 percent of hospitals were participating in operational health information exchange efforts.
Marchibroda wrote that the failure to develop healthcare information exchanges was due to “the lack of a business case for information sharing, the cost associated with exchange, and the lack of standards adoption and interoperability of systems.”
The business model driving much of the healthcare system needs to be altered to create an environment in which information exchanges can flourish, the report said.