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Study: Health Information Exchanges Improve Care, Reduce Costs

June 5, 2018
by Heather Landi
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An updated systematic review of recent studies of health information exchanges found evidence the HIEs reduced both the cost of healthcare and its use, according to researchers at Indiana University.

These findings contrast with an assessment published three years ago that found little such evidence, the researchers note.

The new findings “represent progress in reaching the national goals of better-quality care, improved population health and lower costs," Nir Menachemi, a professor in the Indiana University Richard M. Fairbanks School of Public Health at IUPUI, chair of the school's Department of Health Policy and Management, and the study's lead investigator, said. This latest study was recently published in the Journal of the American Medical Informatics Association.

Researchers, led by Menachemi, sought to review the recent literature on the impact of HIEs. The current review focused on 24 articles including 63 health information exchange analyses that were published between May 2014 and June 2017. Among all analyses, 68.3 percent reported a beneficial effect from health information exchanges, and 7.9 percent reported an unexpected adverse effect. The remaining analyses reported no effect.

The systematic review found that studies with more rigorous designs all reported benefits from HIE, the researchers noted, and benefits included fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety.

When the first systematic review of health information exchanges was published in 2015, only weak evidence was reported linking health information exchanges to reduced costs, use of health services or quality of care, Menachemi noted, who also was the lead investigator of that previous review.

“Up until this point, the promise of health information exchanges to improve care and reduce costs has been theoretical,” Menachemi said in a statement published in a press release about the study. “We now have reasonably strong evidence that there are benefits to using health information exchanges."

Several reasons might explain why there is a difference when it comes to the evidence between the two reviews, Menachemi said. One might be that the more current studies were examining more mature health information exchanges that have evolved to be more effective than earlier-generation systems.

“Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs,” the researchers wrote.

Researchers found community health information exchanges were more likely to produce benefits than proprietary or enterprise health information exchanges. Community health information exchanges are those in which any provider in a community can share information about any patient. Proprietary health information exchanges are those that limit access, for example, to just one hospital and certain health care providers.

“It looks like community health information exchanges might be more likely to achieve improved outcomes,” Menachemi said.

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