Dataset Information

Sharing information electronically with other hospitals is associated with increased sharing of patients.

ABSTRACT:

Objective

One potential benefit of greater electronic health information exchange is a reduction in the effort required for patients to switch between providers. We therefore assessed whether hospital participation in health information organizations (HIOs) led to increased patient sharing.

Data sources

Secondary data from 2010 to 2016.

Study design

Using hospital-pair and year fixed effects regression models, we assessed change in patient sharing volume following HIO participation by hospitals and compared the effect by the level of market competition and by hospital size.

Data extraction methods

We used national data on hospital participation in HIOs from the American Hospital Association Information Technology Supplement and data on the volume of Medicare patients shared between pairs of hospitals from 2010 to 2016.

Principal findings

The volume of patients shared between hospitals increased by 2.6 percent when both hospitals participated in a health information organization (P = .008, 95% CI: 0.7%-4.5%). This increase was greater in competitive markets (3.1 percent increase, P = .03 95% CI: 0.3%-5.9%) and between large hospitals (4.3 percent increase, P = .007 95% CI: 1.2%-7.3%). Participation by only one hospital in a pair had no effect on patient sharing.

Conclusions

Our results suggest that an important policy goal motivating the investment in health information exchange has been at least partially achieved. However, our results also support hospital concerns about the competitive implications of engaging in health information exchange. HIO participation appears to facilitate patient movement between hospitals, likely by lowering switching costs and resulting in greater competition.

SUBMITTER: Everson J

PROVIDER: S-EPMC6980958 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Sharing information electronically with other hospitals is associated with increased sharing of patients.

Everson Jordan J Adler-Milstein Julia J

Health services research 20191112 1

<h4>Objective</h4>One potential benefit of greater electronic health information exchange is a reduction in the effort required for patients to switch between providers. We therefore assessed whether hospital participation in health information organizations (HIOs) led to increased patient sharing.<h4>Data sources</h4>Secondary data from 2010 to 2016.<h4>Study design</h4>Using hospital-pair and year fixed effects regression models, we assessed change in patient sharing volume following HIO parti ...[more]

PMID: 31721183

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Project description:Coordination of services used by palliative care patients across care contexts is essential in providing patient centred care. In Lothian, Edinburgh, a baseline audit in 2008 of patients known to all four specialist palliative care teams revealed only 49% had information available to out of hours (OOH) general practitioners (GPs). This highlighted the poor handover and sharing of information, which are essential for providing quality care for palliative patients in accordance with their wishes, and for reducing inappropriate hospital admissions. A number of quality improvement measures have been introduced, some nationally in Scotland, such as the roll out of Electronic Palliative Care Summaries (ePCS) - an electronic register containing up to date information including patient wishes and latest treatment decisions. In addition there have been changes to the GP Quality Outcomes Framework encouraging the use of electronic records. Locally, at Marie Curie Hospice, drivers were implemented including hosting GP education evenings promoting ePCS use, alteration of hospice discharge letter format to complement ePCS completion, in addition to offering specialist nurse support and presence at GP practice palliative care register meetings. A re-audit in 2012 revealed that 75% of specialist palliative care patients had electronic information available to OOH services, and in 2013, 71% of patients. This represents a significant improvement in electronic information sharing across care contexts. Building on the progress of ePCS, a new Electronic Key Information Summary is currently being rolled out across Scotland. This quality improvement report reflects on the positive measures taken to address the important clinical need of effective electronic handover for specialist palliative care patients in Lothian. Furthermore, it highlights the ongoing requirement to continue to improve the quality and availability of electronically shared information for every patient known to palliative care services across care contexts.

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Dataset Information

Sharing information electronically with other hospitals is associated with increased sharing of patients.

Objective

Data sources

Study design

Data extraction methods

Principal findings

Conclusions

Publications

Sharing information electronically with other hospitals is associated with increased sharing of patients.

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