The Value of Health Information Exchange Use: The Impact of Patient and Locations Characteristics
40 Pages Posted: 21 Jun 2018 Last revised: 18 Mar 2019
Date Written: June 5, 2018
In this paper, we investigate the impact of Health Information Exchange (HIE) use at the visit-level on patient outcomes, such as number of procedures/tests, readmissions, and length of stay. Timely sharing of patient information can decrease fragmentation of care and improve decision-making, diagnoses, and care plans. This in turn can result in fewer readmissions, duplicate tests and procedures. The empirical studies that examine the benefits of HIE use are not unanimous and generally limited to average effects with the data available to these researchers. The goal of this study is to get a deeper understanding on how patient characteristics (such as having a chronic condition) and fragmentation of care (patient movements between hospitals) impact the benefits of HIE use. We utilize a rich dataset from an HIE provider in New York. Notably, one of the unique features of our data is information on HIE use in each patient visit, which provides a detailed understanding of the extent of HIE use, going beyond hospital level adoption. Observing HIE use at the encounter level also allows us to examine heterogeneous effects for different patient populations and when they switch hospitals. Our results show that HIE use decreases future readmissions and the number of future encounters, and these effects are significantly stronger for chronic patients compared to non-chronic patients. Further, HIE use decreases the length of stay and number of procedures done at the focal visit. The benefits for chronic patients accrue to both their chronic and non-chronic visits. Additionally, while hospital switches are associated with inefficiencies such as longer length of stay and more procedures being performed, we show that HIE use could effectively address these inefficiencies and reverse their effects, leading to overall net benefits. Results from this study have important implications for policy makers, healthcare providers, and patients.
Keywords: Health IT, health information exchange, care coordination, chronic disease management, care fragmentation
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