HIE Among Hospitals Grows, Still Needs Improvement

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More than six in 10 hospitals last year electronically exchanged health information with outside providers--a 51 percent increase since 2008--according to results of the 2013 American Hospital Association annual Health IT survey posted online by ONC. However, there are still areas of HIE that are in need of significant improvement. 

AHA survey data from 2008 to 2013 indicates progress in electronic HIE among non-federal acute care hospitals. The majority of hospitals (57 percent) electronically exchanged health information with ambulatory providers outside of their system--a 58 percent increase since 2008. And, four in 10 hospitals electronically exchanged health information with hospitals outside of their system--a whopping 167 percent increase since 2008. 

Nevertheless, hospital HIE with outside providers varied by data type. Though more than half of hospitals exchanged laboratory results (57 percent) and radiology reports (55 percent) with outside providers, fewer exchanged clinical care summaries (42 percent) and medication history (37 percent). In addition, only four in ten hospitals could send and receive secure electronic messages containing patient health information to and from external systems and a little more than half were able to electronically request and retrieve patient health information from sources outside their organization.

What's more, in 2013, less than half of hospitals routinely electronically notified a patient’s primary care provider inside their system when they entered an emergency room, and roughly one-quarter notified primary care providers outside of their system. Still worse, only one in ten hospitals provided their patients with the ability to transmit information from their medical record to a third party.

"Our previous analysis of AHA survey data found that EHR adoption, in combination with participation in a regional health information organization was associated with the highest rates of exchange of different types of health information across organizations," states a May 5 ONC blog reporting the results. 

"We anticipate that the exchange of care summaries among hospitals will increase as hospitals implement EHRs certified to meet ONC’s 2014 health IT certification regulation, which require secure messaging functionality and standardized clinical care summary structure and content," write Matthew Swain, program analyst in the ONC Office of Economic Analysis, Evaluation, and Modeling, and Erica Galvez, interoperability and exchange portfolio manager at ONC.

They note that "meaningful use-eligible hospitals must use this certified functionality (or services from an eHealth Exchange participant) to achieve meaningful use Stage 2 transition of care requirements." Stage 2 of the Medicare and Medicaid EHR Incentive Programs requires hospitals to exchange clinical information using a certified EHR to receive incentive payments.

Over the last five years, hospital adoption of EHR systems has increased more than five-fold, according to the results of the 2013 AHA Health IT survey reported by ONC. Last year, more than nine out of 10 hospitals possessed EHR technology certified as meeting federal requirements for meaningful use objectives. And, nearly six in 10 hospitals adopted at least a basic EHR system with clinician notes, representing a 34 percent increase from the previous year and a more than five-fold increase in EHR adoption since 2008. Adoption of comprehensive EHR systems has increased eight-fold since 2009, rising to more than a quarter (26 percent) of hospitals in 2013.


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