Hospital HIE Use Up 41%, ONC Says

Six in 10 hospitals routinely swapped electronic health information with healthcare providers and health systems beyond their walls in 2012, says a study from the Office of the National Coordinator for Health Information Technology.

Health information exchanges between hospitals and other providers jumped 41% from 2008 to 2012, according to federal government research published this week in Health Affairs.

The study, led by National Coordinator for Health Information Technology, Farzad Mostashari, MD, examined national surveys and found that six in 10 hospitals routinely swapped electronic health information with providers and hospitals beyond their walls in 2012.

"EHR adoption and HIE participation were associated with significantly greater hospital exchange activity, but exchanges with providers outside the organization and exchanges of clinical care summaries and medication lists remained limited," the study said.  

"New and ongoing policy initiatives and payment reforms may accelerate the electronic exchange of health information by creating new data exchange options, defining standards for interoperability, and creating payment incentives for information sharing across organizational boundaries."  

Mostashari said research suggests that EHRs and HIEs are complementary tools used to enable health information exchange. Stage 2 Meaningful Use, which requires hospitals to exchange data with outside organizations using different EHRs, and to share summary of care records during transitions of care, can accelerate hospital use of HIE to enhance care quality and safety. 

"We know that the exchange of health information is integral to the ongoing efforts to transform the nation's health care system and we will continue to see that grow as more hospitals and other providers adopt and use health IT to improve patient health and care," Mostashari said in prepared remarks. "Our new research is crystal clear: health information exchange is happening and it is growing. But we still have a long road ahead toward universal interoperability."

It's not clear if the government-sponsored research will assuage the misgivings of leading provider organizations that have asked the federal government to dial back the implementation dates for hospital Stage 2 Meaningful Use, which go into effect on Oct. 1 for hospitals and on Jan. 1, 2014 for physicians. Last month the American Hospital Association and the American Medical Association sent a joint letter to Health and Human Services Secretary Kathleen Sebelius telling her the requirements for Stage 2 MU were "overly burdensome."

"Our members, and the vendors they work with, report growing concerns that the rapidly approaching start date for Stage 2 is on a trajectory that will not provide enough time or adequate flexibility for a safe and orderly transition unless certain changes are made," AHA President/CEO Rich Umbdenstock and AMA CEO James. L Madara, MD, said in the letter.

"As of July 17, the official federal list of certified vendor products shows only nine complete 2014 Edition certified EHRs for the inpatient setting, produced by only six vendors. By comparison, the list shows 313 complete 2011 Edition certified inpatient EHRs. On the ambulatory side, only 11 complete 2014 Edition certified EHRs are listed, while about 1,300 were certified for 2011."  

The Office of the National Coordinator for Health Information Technology study found that:

• 58% of hospitals exchanged data with providers outside their organization in 2012 and hospitals' exchanges with other hospitals outside their organization more than doubled during the study period.
• Hospitals with basic EHR systems and participating in HIEs had the highest rates of hospital exchange activity in 2012, regardless of the organizational affiliation of the provider exchanging data or the type of clinical information exchanged.
• The proportion of hospitals that adopted at least a basic EHR and participated in an HIE grew more than fivefold from 2008 to 2012.
• Between 2008 and 2012, there were significant increases in the percent of hospitals exchanging radiology reports, laboratory results, clinical care summaries, and medication lists with hospitals and providers outside of their organization.
• 84% of hospitals that adopted an EHR and participated in a regional HIE exchanged information with providers outside their organization.

Mostashari said more research is needed for care summaries and medication lists because only about one-third of hospitals exchanged clinical care summaries or medication lists with outside providers.