The associations between query‐based and directed health information exchange with potentially avoidable use of health care services

Abstract

Objective To quantify the impact of two approaches (directed and query‐based) to health information exchange (HIE) on potentially avoidable use of health care services. Data Sources/Study Setting Data on ambulatory care providers’ adoption of HIE were merged with Medicare fee‐for‐service claims from 2008 to 2014. Providers were from 13 counties in New York served by the Rochester Regional Health Information Organization (RHIO). Study Design Linear regression models with provider and year fixed effects were used to estimate changes in the probability of utilization outcomes for Medicare beneficiaries attributed to providers adopting directed and/or query‐based HIE compared with beneficiaries attributed to providers who had not adopted HIE. Data Collection Providers’ HIE adoption status was determined through Rochester RHIO registration records. RHIO and claims data were linked via National Provider Identifiers. Principal Findings Query‐based HIE adoption was associated with a 0.2 percentage point reduction in the probability of an ambulatory care sensitive hospitalization and a 1.1 percentage point decrease in the likelihood of an unplanned readmission. Directed HIE adoption was not associated with any outcome. Conclusions The Centers for Medicare & Medicaid Services’ (CMS) EHR certification criteria includes requirements for directed HIE, but not query‐based HIE. Pending further research, certification criteria should place equal weight on facilitating query‐based and directed exchange.

Pregnancy After Concussion: A Clarion Call for Attention?

“…The RHIO is a regional service that allows a medical care team to share records across institutions and practices, making patient information available wherever and whenever needed to provide the highest quality care. Twenty-one hospitals and more than two-thirds of the region's physicians participate in the RHIO, which facilitates exchange for more than 1.4 million patients 51. The RHIO provides health information exchange services for primary care, specialty care, emergency, public health, inpatient, and long-term care sites 50,51.…”

“…50,51 Available data include laboratory results, radiology reports and imaging, clinical documents (eg, discharge summaries, histories, and operative notes), encounter-based records, contact information, and clinical care documents. 51 Peer-reviewed publications of the Rochester RHIO have been used to inform patient admission rates and quality of care. [50][51][52] Definitions of the terms were discussed as a team with the involvement of V.L., the reproductive endocrinologist and OB/GYN expert on the study team.…”

“…51 Peer-reviewed publications of the Rochester RHIO have been used to inform patient admission rates and quality of care. [50][51][52] Definitions of the terms were discussed as a team with the involvement of V.L., the reproductive endocrinologist and OB/GYN expert on the study team. Initial chart reviews were conducted by V.C., and subsequently reviewed by M.A.O.…”

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

“…Furthermore, the use of HISs at the point of care has shown positive impacts on clinical processes and patient health in multiple settings of care [ 15 ]. The adoption of health information exchange (HIE) programs has proven to lessen utilization of health care services, such as ambulatory care and hospital readmissions, and allow smooth transition from inpatient to outpatient care [ 16 , 17 ].…”

Enterprise Architecture Institutionalization for Health Information Exchange (HIE) Cloud Migration

“…With this solution, HIEs functioning as a data transfer point through which records are transmitted. Both HIE solutions utilize health data standards like Continuity of Care Document (CCD), DIRECT Secure Messaging, and other "push" triggered transmissions to ensure records are transferred [3].…”