title: The potential for community-based health information exchange systems to reduce hospital readmissions.
abstract: BACKGROUND
  Hospital readmissions are common, costly, and offer opportunities for utilization reduction. Electronic health information exchange (HIE) systems may help prevent readmissions by improving access to clinical data by ambulatory providers after discharge from the hospital.
  
  
  OBJECTIVE
  We sought to determine the association between HIE system usage and 30-day same-cause hospital readmissions among patients who consented and participated in an operational community-wide HIE during a 6-month period in 2009-2010.
  
  
  METHODS
  We identified a retrospective cohort of hospital readmissions among adult patients in the Rochester, New York area. We analyzed claims files from two health plans that insure more than 60% of the area population. To be included in the dataset, patients needed to be continuously enrolled in the health plan with at least one encounter with a participating provider in the 6 months following consent to be included in the HIE system. Each patient appeared in the dataset only once and each discharge could be followed for at least 30 days.
  
  
  RESULTS
  We found that accessing patient information in the HIE system in the 30 days after discharge was associated with a 57% lower adjusted odds of readmission (OR 0.43; 95% CI 0.27 to 0.70). The estimated annual savings in the sample from averted readmissions associated with HIE usage was $605 000.
  
  
  CONCLUSIONS
  These findings indicate that usage of an electronic HIE system in the ambulatory setting within 30 days after hospital discharge may effectively prevent hospital readmissions, thereby supporting the need for ongoing HIE efforts.
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA Health Information Technology Evaluation Collaborative, New York, New York, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA Health Information Technology Evaluation Collaborative, New York, New York, USA Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA Health Information Technology Evaluation Collaborative, New York, New York, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Silver
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA Health Information Technology Evaluation Collaborative, New York, New York, USA Department of Medicine, Weill Cornell Medical College, New York, New York, USA Department of Pediatrics, Weill Cornell Medical College, New York, New York, USA NewYork-Presbyterian Hospital, New York, New York, USA.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D066264:Datasets as Topic; D066275:Health Information Exchange; D063005:Health Information Systems / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D007345:Insurance Claim Review; D007348:Insurance, Health; D008875:Middle Aged; D009518:New York; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055815:Young Adult
keywords: American Recovery and Reinvestment Act; Health Policy; Health information exchange; Patient Admission; Patient Readmission
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