Seems Health Information Exchange Might Not Make The Scale Of Difference Hoped For.

This appeared a little while ago.

HIE not 'causally related' to cost improvements, care quality benefits

March 3, 2015 | By Dan Bowman

An examination of health information exchange research published this month in Health Affairs determines that despite an increase in the sharing of health data across organizations, benefits on costs and care quality are scarce.

For the study, the researchers--from the University of Alabama at Birmingham, Weill Cornell Medical College in New York and Indiana University--analyzed 27 articles that included 94 individual analyses. For each discrete analysis, the researchers then determined whether or not a beneficial relationship existed between the exchange of health data and the outcomes.

Overall, 54 analyses found beneficial effects of health information exchange. However, the researchers argued, of six studies that used designs with strong internal validity--those "capable of identifying causal relationships"--only two found beneficial results.

"Despite the abundance of observational studies finding a beneficial relationship between HIE and outcomes, there is currently no strong evidence to suggest that HIE is causally related to any widespread generalizable benefits," the authors said.

The authors submitted that most of the studies they examined focused on "first-generation" iterations of health information exchange systems, as well as on institutions where active HIE usage was low. Continued meaningful use of such systems, they added, could likely enable better evaluation adoption.

Lots more here:

http://www.fiercehealthit.com/story/hie-not-causally-related-cost-improvements-care-quality-benefits/2015-03-03

Here is the published 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

Given that it would be hard to describe the PCEHR as much more than a pretty weak attempt at a Health Information Exchange - seems we really need to check that it is making a difference before spending too much more!

See also the first link from yesterday for confirmation of the view.

http://www.fiercehealthit.com/story/studies-hie-benefits-few-and-far-between/2015-12-18

Happy Christmas knowing that the PCEHR is probably a major ongoing waste of money!

David.