Info exchanges not reaching potential: Harvard researchers

A team of Harvard researchers took a comprehensive look at the state of regional health information exchanges across the country and found the numbers—from a health information technology policy perspective—to be disturbing.

Their findings "call into question whether RHIOs in their current form can be self-sustaining and effective in helping U.S. physicians and hospitals engage in robust HIE to improve the quality and efficiency of care," the researchers wrote in an article, "A survey of health information exchange organizations in the United States: Implications for meaningful use," appearing online in the Annals of Internal Medicine.

The federal government has promoted regional information exchanges as a tool to enable interoperability among electronic health-record systems since the early days of Dr. David Brailer's regime as the first head of the Office of the National Coordinator for Health Information Technology in 2004.

The Harvard team's research, funded by the ONC, sent surveys to 197 exchange organizations, received status reports from 179 (91%) and completed surveys from 165 (84%). Just 75 of the exchanges (38%) were operational—providing some form of exchange service to about 14% of U.S. hospitals and 3% of ambulatory practices, the researchers concluded. Only 13 exchange organizations (or 7% of the national total) supported Stage 1 meaningful-use requirements, the research team said. Of the 75 functioning RHIOs, 50 failed to meet researchers' criteria for financial viability.

"Health information exchange is central to improving our healthcare delivery system, because it offers providers the ability to have complete, timely information at the point of care," the authors wrote. This has been a focus of substantial efforts from policymakers, and Congress specified it as a key part of meaningful use."

They continued: "Our findings offer reasons for optimism but also concern. Although the number of RHIOs has grown substantially and nearly 14% of hospitals now participate in an RHIO, the participation rate among practices is much lower. … Of greater concern, we found no organizations that support the robust data exchange that is probably required to realize the projected quality and efficiency gains from HIE."