Abstract
Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users’ accessed patients’ data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.
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The author thanks the staff of the Integrated Care Collaboration of Central Texas, particularly Sandy Coe Simmons; and from TAMHSC SRPH Dr. Charles Phillips, SangNam Ahn, Patricia Moore, Darcy Moudouni and Laura Wills for helpful comments and suggestions.
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Vest, J.R. Health Information Exchange and Healthcare Utilization. J Med Syst 33, 223–231 (2009). https://doi.org/10.1007/s10916-008-9183-3
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DOI: https://doi.org/10.1007/s10916-008-9183-3