title: The Number Of Health Information Exchange Efforts Is Declining, Leaving The Viability Of Broad Clinical Data Exchange Uncertain.
abstract: The diffusion of health information exchange (HIE), in which clinical data are electronically linked to patients in many different care settings, is a top priority for policy makers. To drive HIE, community and state efforts were federally funded to broadly engage providers in exchanging data in ways that improved patient care. To assess the current landscape, we conducted a national survey of community and state HIE efforts soon after federal funding ended. We found 106 operational HIE efforts that, as a group, engaged more than one-third of all US providers in 2014. However, the number of operational HIE efforts is down from 119 in 2012, representing the first decline observed since the tracking of these efforts began in 2006. Only half of operational efforts reported being financially viable, and all efforts reported a variety of barriers to continuation. These findings raise important questions about whether the current vision for HIE efforts will allow for the broad exchange of clinical data, or whether alternative approaches would be more successful.
authors.affiliation: Julia Adler-Milstein (juliaam@umich.edu) is an assistant professor in the School of Information, University of Michigan, with a joint appointment in the Department of Health Management and Policy, School of Public Health, University of Michigan, in Ann Arbor.
authors.forename: Julia
authors.initials: J
authors.lastname: Adler-Milstein
authors.affiliation: Sunny C. Lin is a doctoral candidate in health management and policy at the University of Michigan.
authors.forename: Sunny C
authors.initials: SC
authors.lastname: Lin
authors.affiliation: Ashish K. Jha is the K. T. Li Professor of International Health at the Harvard T. H. Chan School of Public Health in Boston, and director of the Harvard Global Health Institute in Cambridge, both in Massachusetts.
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
mesh_terms: D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D066275:Health Information Exchange / Q000191:economics* / Q000706:statistics & numerical data*; D006282:Health Personnel / Q000458:organization & administration; D006306:Health Surveys; D006801:Humans; D033181:Information Dissemination; D008297:Male; D062527:Meaningful Use; D017063:Outcome Assessment, Health Care; D035501:Uncertainty; D014481:United States
keywords: Information Technology