The majority of hospitals still do not engage in the electronic exchange of health information, despite strong federal policies designed to encourage these exchanges and a substantial investment in health information technology.

That is the finding of a study by researchers from the University of Michigan and Harvard University. The study, written by Julia Adler-Milstein from the University of Michigan and Ashish K. Jha, of Harvard, sought to assess whether current policy efforts--many of which are being developed by states--appear to be tackling the key barriers to hospital participation in health information exchange.

The researchers found that only 30 percent of U.S. hospitals engaged in health information exchange with unaffiliated providers. There was large variation in state-level participation, with some states achieving more than 70 percent participation (Rhode Island, Delaware and Vermont) and others with minimal participation. In markets where exchange occurred, for-profit hospitals were far less likely to engage in HIE than non-profit hospitals. Hospitals with a larger market share were more likely to engage in exchange, as were hospitals in less competitive markets.

Their conclusion is that despite an uptick in hospital HIE participation since the start of the 2009 HITECH Act, the majority of hospitals still do not engage in HIE and there is large state-to-state variation. Specific types of hospitals appear to feel that they are better off not engaging in HIE.

Stronger policies and incentives may be necessary to convince organizations to share their data electronically. The authors state that “Pursuing these is critical to ensuring that the highly anticipated quality and efficiency gains from our large national investment in health information technology are realized.”

The study, published in Healthcare: The Journal of Delivery Science and Innovation, is available here.

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