TY - JOUR
T1 - Outcomes from health information exchange
T2 - Systematic review and future research needs
AU - Hersh, William R.
AU - Totten, Annette M.
AU - Eden, Karen B.
AU - Devine, Beth
AU - Gorman, Paul
AU - Kassakian, Steven Z.
AU - Woods, Susan S.
AU - Daeges, Monica
AU - Pappas, Miranda
AU - McDonagh, Marian S.
N1 - Publisher Copyright:
© 2015 JMIR Publications Inc.. All right reserved.
PY - 2015/10
Y1 - 2015/10
N2 - Background: Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations, has been promoted to improve the efficiency, cost-effectiveness, quality, and safety of health care delivery. Objective: To systematically review the available research on HIE outcomes and analyze future research needs. Methods: Data sources included citations from selected databases from January 1990 to February 2015. We included English-language studies of HIE in clinical or public health settings in any country. Data were extracted using dual review with adjudication of disagreements. Results: We identified 34 studies on outcomes of HIE. No studies reported on clinical outcomes (eg, mortality and morbidity) or identified harms. Low-quality evidence generally finds that HIE reduces duplicative laboratory and radiology testing, emergency department costs, hospital admissions (less so for readmissions), and improves public health reporting, ambulatory quality of care, and disability claims processing. Most clinicians attributed positive changes in care coordination, communication, and knowledge about patients to HIE. Conclusions: Although the evidence supports benefits of HIE in reducing the use of specific resources and improving the quality of care, the full impact of HIE on clinical outcomes and potential harms are inadequately studied. Future studies must address comprehensive questions, use more rigorous designs, and employ a standard for describing types of HIE.
AB - Background: Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations, has been promoted to improve the efficiency, cost-effectiveness, quality, and safety of health care delivery. Objective: To systematically review the available research on HIE outcomes and analyze future research needs. Methods: Data sources included citations from selected databases from January 1990 to February 2015. We included English-language studies of HIE in clinical or public health settings in any country. Data were extracted using dual review with adjudication of disagreements. Results: We identified 34 studies on outcomes of HIE. No studies reported on clinical outcomes (eg, mortality and morbidity) or identified harms. Low-quality evidence generally finds that HIE reduces duplicative laboratory and radiology testing, emergency department costs, hospital admissions (less so for readmissions), and improves public health reporting, ambulatory quality of care, and disability claims processing. Most clinicians attributed positive changes in care coordination, communication, and knowledge about patients to HIE. Conclusions: Although the evidence supports benefits of HIE in reducing the use of specific resources and improving the quality of care, the full impact of HIE on clinical outcomes and potential harms are inadequately studied. Future studies must address comprehensive questions, use more rigorous designs, and employ a standard for describing types of HIE.
KW - Diagnostic tests
KW - Health information exchange
KW - Outcome assessment (health care)
KW - Patient readmission
KW - Routine
KW - Systematic review
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U2 - 10.2196/medinform.5215
DO - 10.2196/medinform.5215
M3 - Review article
AN - SCOPUS:84975161662
SN - 2291-9694
VL - 3
JO - JMIR Medical Informatics
JF - JMIR Medical Informatics
IS - 4
M1 - e39
ER -