The national experience with HIE is growing, both in terms of the number of sites exploring this technology16 17 and the business models that rely on it. Unfortunately, because of the economic immaturity of HIE, most HIE benefits are estimates.18–20 Reports of measurable financial benefit are few in number.21 22
Presenting convincing evidence is a challenge because of the relatively small but growing number of HIE efforts, the differences in HIE, the ways in which HIE is enabled and used, and the methodology challenge of measuring value in ‘real world’ settings. Although HIE among institutions usually takes place through a single intermediary HIO, as more organizations share data with one another on a point-to-point basis, measuring the marginal contribution of each external data source and thus the overall value of HIE will become even more problematical.23
As part of our 6-year effort providing access to clinical and administrative data through a single HIO supporting HIE for every consenting patient treated in any of the region’s major hospitals and in some ambulatory care clinics, we conducted a 2-year study examining overall use, user perspectives, and a range of other factors.24–26 We report here the direct financial impact study results by determining how HIE data access by emergency department (ED) physicians affected hospital admissions and diagnostic testing.
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