Dataset Information

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

ABSTRACT:

Objective

To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both.

Study setting

A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016.

Study design

Hospital-level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percent of care transitions with summary of care records (SCRs) sent electronically to subsequent providers.

Principal findings

Stage 2 hospitals reported sending SCRs electronically for an average of 41 percent (median = 33 percent) of transitions. HIE level is related to four capability measures, one incentive measure, and one measure that is related to both capability and incentive. Percent of transitions with SCRs sent electronically was 3 percentage points higher (95 percent CI: 0.1-5.1) for hospitals with a third-party HIE vendor, 3 percentage points higher (95 percent CI: 0.5-5.4) for hospitals with an EHR vendor as their HIE vendor, and 3 percentage points higher (95 percent CI: 0.4-5.4) for hospitals that automatically alert primary care providers. The direction and statistical significance of the relationships between specific EHR vendor and electronic SCR transmission level varied by vendor. Nonprofits and government hospitals performed 5 percentage points higher (95 percent CI: 1.5-9.1) and 8 percentage points higher (95 percent CI: 3.4-12.3) than for-profits. Hospitals in systems performed 3 percentage points higher (95 percent CI: 0.8-6.1).

Conclusion

The overall level of HIE is low, with hospitals sending an SCR electronically for less than half of patient transitions. Specific hospital characteristics related to both technology capabilities and incentives were associated with higher levels of HIE.

SUBMITTER: Lin SC

PROVIDER: S-EPMC6153171 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

Lin Sunny C SC Everson Jordan J Adler-Milstein Julia J

Health services research 20180228 5

<h4>Objective</h4>To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both.<h4>Study setting</h4>A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016.<h4>Study design</h4>Hospital-level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percen ...[more]

PMID: 29492959

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Project description:BackgroundNowadays, a number of mechanisms and tools are being used by health care organizations and physicians to electronically exchange the personal health information of patients. The main objectives of different methods of health information exchange (HIE) are to reduce health care costs, minimize medical errors, and improve the coordination of interorganizational information exchange across health care entities. The main challenges associated with the common HIE systems are privacy concerns, security risks, low visibility of system transparency, and lack of patient control. Blockchain technology is likely to disrupt the current information exchange models utilized in the health care industry.ObjectiveLittle is known about patients' perceptions and attitudes toward the implementation of blockchain-enabled HIE networks, and it is still not clear if patients (as one of the main HIE stakeholders) are likely to opt in to the applications of this technology in HIE initiatives. Thus, this study aimed at exploring the core value of blockchain technology in the health care industry from health care consumers' views.MethodsTo recognize the potential applications of blockchain technology in health care practices, we designed 16 information exchange scenarios for controlled Web-based experiments. Overall, 2013 respondents participated in 16 Web-based experiments. Each experiment described an information exchange condition characterized by 4 exchange mechanisms (ie, direct, lookup, patient-centered, and blockchain), 2 types of health information (ie, sensitive vs nonsensitive), and 2 types of privacy policy (weak vs strong).ResultsThe findings show that there are significant differences in patients' perceptions of various exchange mechanisms with regard to patient privacy concern, trust in competency and integrity, opt-in intention, and willingness to share information. Interestingly, participants hold a favorable attitude toward the implementation of blockchain-based exchange mechanisms for privacy protection, coordination, and information exchange purposes. This study proposed the potentials and limitations of a blockchain-based attempt in the HIE context.ConclusionsThe results of this research should be of interest to both academics and practitioners. The findings propose potential limitations of a blockchain-based HIE that should be addressed by health care organizations to exchange personal health information in a secure and private manner. This study can contribute to the research in the blockchain area and enrich the literature on the use of blockchain in HIE efforts. Practitioners can also identify how to leverage the benefit of blockchain to promote HIE initiatives nationwide.

Dataset Information

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

Objective

Study setting

Study design

Principal findings

Conclusion

Publications

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

Similar Datasets

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