Office of Economic Analysis, Evaluation, and Modeling, Department of Health and Human Services, Washington, DC, USA.
Health Aff (Millwood). 2013 Aug;32(8):1346-54. doi: 10.1377/hlthaff.2013.0010.
Electronic health information exchange can improve care coordination for patients by enabling more timely and complete sharing of clinical information among providers and hospitals. Approaches to health information exchange have expanded in recent years with the growth in entities such as regional health information organizations (HIOs) and the increased adoption of electronic health record (EHR) systems. However, little is known about the extent of exchange activity in US hospitals. Using national surveys of hospitals, we found that between 2008 and 2012, hospitals' electronic exchange of health information with other providers increased significantly, regardless of provider type, organizational affiliation, or type of clinical information. In 2012 nearly six in ten hospitals actively exchanged electronic health information with providers and hospitals outside their organization, an increase of 41 percent since 2008. EHR adoption and HIO participation were associated with significantly greater hospital exchange activity, but exchanges with providers outside the organization and exchanges of clinical care summaries and medication lists remained limited. New and ongoing policy initiatives and payment reforms may accelerate the electronic exchange of health information by creating new data exchange options, defining standards for interoperability, and creating payment incentives for information sharing across organizational boundaries.
电子健康信息交换可以通过在提供者和医院之间更及时和完整地共享临床信息来改善患者的护理协调。近年来,随着区域健康信息组织 (HIO) 的发展和电子健康记录 (EHR) 系统的广泛采用,健康信息交换方法有了很大的扩展。然而,对于美国医院的交换活动的程度,我们知之甚少。我们利用对医院的全国性调查发现,在 2008 年至 2012 年间,无论提供者类型、组织隶属关系或临床信息类型如何,医院与其他提供者之间的电子健康信息交换都显著增加。2012 年,近六成的医院积极与组织外的提供者和医院进行电子健康信息交换,自 2008 年以来增加了 41%。EHR 的采用和 HIO 的参与与医院的交换活动显著相关,但与组织外的提供者的交换以及临床护理摘要和药物清单的交换仍然有限。新的和正在进行的政策举措和支付改革可能会通过创建新的数据交换选项、为互操作性定义标准以及为跨越组织边界的信息共享创造支付激励措施,加速健康信息的电子交换。