Impacts of Patient Characteristics and Care Fragmentation on the Value of HIEs

Abstract

We investigate the impact of health information exchange (HIE) use at the visit level on patient outcomes, such as future visit behavior and the number of procedures performed on the patient, and how the effects differ across patient and visit characteristics, for example, whether a patient has chronic conditions and whether a visit involves a hospital switch. Timely sharing of patient information is expected to decrease the fragmentation of care and improve decision‐making, diagnoses, and care plans, yet previous studies that examine the benefits of HIE use do not focus on these issues and are not unanimous in their findings in general about the benefits of HIEs. Further, prior studies generally focus on average effects with binary HIE measures, either using HIE adoption at the hospital level or whether HIE is accessed at the visit level. We argue that the benefits of HIE stem from the information contained within and are not equal across cases. We utilize a rich dataset of medical records from an HIE provider in New York. Our results show that the depth of information available for the patient in HIE use decreases the overall number of future visits, specifically, HIE use effectively reduces visits that are not preventative in nature while increases adherence to preventative care visits, aiding in the shift from treatment‐based care to preventative‐based care, that public health organizations have urged for. Further, HIE use lowers the number of procedures done at the focal visit. We have several other findings that have important implications for policymakers, healthcare providers, and patients.

Hospital and surgeon experience and patient health outcomes after coronary artery bypass graft surgery

“…The IV for nonfocal hospital experience, , is calculated as the average number of CABG surgeries performed at hospital h 's peer hospitals by surgeons other than surgeon d during the 30 days before time t . Both and satisfy the relevance and exclusion conditions and are consistent with IV selection in other healthcare studies (Atasoy et al, 2021).…”

Care Fragmentation Following Hospitalization for Atrial Fibrillation in the United States

“… 19 , 20 , 21 Thus, care teams at nonindex hospitals may benefit from interhospital health information exchange systems to inform decision-making and deliver more efficient care. 9 , 18 , 22 Given the limitations of national studies, analyses of factors that are responsible for the poor outcomes associated with CF in more granular datasets are needed.…”

Planning and scheduling in healthcare for better care coordination: Current understanding, trending topics, and future opportunities

“…Meanwhile, Atasoy et al. (2021) find that health information exchanges (HIE) effectively reduce visits that are not preventative, while they increase adherence to preventative care visits, aiding in the shift from treatment‐based care to preventative‐based care. Naturally, future study should focus on better understanding the consequences of virtual care for various stakeholders, such as healthcare planning and scheduling managers, in diverse scenarios.…”

“…The authors demonstrate that systems at capacity may not reap the benefits of e-visits because increased visits by existing patients may reduce capacity for new patients without necessarily generating greater income. Meanwhile, Atasoy et al (2021) find that health information exchanges (HIE) effectively reduce visits that are not preventative, while they increase adherence to preventative care visits, aiding in the shift from treatment-based care to preventative-based care. Naturally, future study should focus on better understanding the consequences of virtual care for various stakeholders, such as healthcare planning and scheduling managers, in diverse scenarios.…”