More Evidence That Health Information Exchange My Not Be All That Beneficial. Worth A Read.

This appeared a little while ago:

Health Information Exchanges Show Little Evidence of Benefits

Greg Slabodkin

MAR 27, 2015 7:42am ET

Though health information exchanges are supposed to improve the speed, quality, safety and cost of patient care, there is little evidence of these benefits in existing HIE studies.

That is the conclusion of a research paper, published in this month’s issue of the journal Health Affairs, in which researchers reviewed 27 studies looking for evidence that HIEs increased efficiency, reduced healthcare costs or improved outcomes.

While researchers found that 57 percent of published analyses reported some benefit from HIE, they also reported that articles employing study designs having strong internal validity—such as randomized controlled trials or quasi-experiments—were significantly less likely than others to associate HIE with benefits.

 “Among six articles with strong internal validity, one study reported paradoxical negative effects, three studies found no effect, and two studies reported that HIE led to benefits,” state the researchers. “Furthermore, these two studies had narrower focuses than the others.”

Two of the six studies found beneficial effects largely as a result of a reduction in diagnostic and imaging tests, associated costs or both, and these studies were based in a single clinic affiliated with an Indiana hospital or in one healthcare system in Israel. Overall, the paper found that “little generalizable evidence currently exists regarding benefits attributable to HIE.”

More here:

http://www.healthdatamanagement.com/news/Health-Information-Exchanges-Show-Little-Evidence-of-Benefits-50059-1.html

Here is the free abstract:

Despite The Spread Of Health Information Exchange, There Is Little Evidence Of Its Impact On Cost, Use, And Quality Of Care

1. Saurabh Rahurkar1,
2. Joshua R. Vest2 and
3. Nir Menachemi3,*

Abstract

Health information exchange (HIE), which is the transfer of electronic information such as laboratory results, clinical summaries, and medication lists, is believed to boost efficiency, reduce health care costs, and improve outcomes for patients. Stimulated by federal financial incentives, about two-thirds of hospitals and almost half of physician practices are now engaged in some type of HIE with outside organizations. To determine how HIE has affected such health care measures as cost, service use, and quality, we identified twenty-seven scientific studies, extracted selected characteristics from each, and meta-analyzed these characteristics for trends. Overall, 57 percent of published analyses reported some benefit from HIE. However, articles employing study designs having strong internal validity, such as randomized controlled trials or quasi-experiments, were significantly less likely than others to associate HIE with benefits. Among six articles with strong internal validity, one study reported paradoxical negative effects, three studies found no effect, and two studies reported that HIE led to benefits. Furthermore, these two studies had narrower focuses than the others. Overall, little generalizable evidence currently exists regarding benefits attributable to HIE.

Here is the link:

http://content.healthaffairs.org/content/34/3/477.abstract

Looks like we will need to wait a little longer to be sure we have HIEs that are working or we need to carefully rethink what is likely to make a real positive difference.

David.