title: Health information exchange in small-to-medium sized family medicine practices: motivators, barriers, and potential facilitators of adoption.
abstract: OBJECTIVE
  For small-to-medium sized primary care practices (those with 20 or fewer clinicians), determine desired functions of health information exchange (HIE) and potential motivators, barriers, and facilitators of adoption.
  
  
  METHODS
  Case study approach with mixed quantitative and qualitative methods. Nine practices in Colorado were purposively selected. Five used paper records and four were already participating in health information exchange.
  
  
  RESULTS
  Practices particularly desired HIE functions to allow anywhere/anytime lookup of test results and to consolidate delivery of test results. HIE-generated quality reporting was the least desired function. Practices were motivated to adopt HIE to improve the quality and efficiency of care, although they did not anticipate financial gains from adoption. The greatest facilitator of HIE adoption would be technical assistance and support during and after implementation. Financial incentives were also valued. Trust in HIE partners was a major issue, and practices with rich professional and social networks appeared to be especially favorable settings for HIE adoption.
  
  
  CONCLUSIONS
  These findings may assist policymakers in promoting adoption of HIE among small-to-medium sized primary care practices, a major component of the US healthcare system.
authors.affiliation: Division of General Internal Medicine, University of Colorado Denver, Aurora, CO, USA. Steve.Ross@ucdenver.edu
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Ross
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Schilling
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Fernald
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Davidson
authors.forename: David R
authors.initials: DR
authors.lastname: West
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D057286:Electronic Health Records / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration*; D055991:Health Records, Personal; D006801:Humans; D008498:Medical Record Linkage / Q000379:methods*; D010818:Practice Patterns, Physicians'