While proponents of health information exchanges (HIEs) say they offer benefits such as faster, safer, less expensive, and higher-quality patient care, there's not much current evidence backing the claims, according to research published in the March issue of Health Affairs.
A team from the University of Alabama at Birmingham and Weill Cornell Medical College in New York City performed a meta-analysis of 27 studies evaluating the benefits of HIEs. While 57% of the studies found benefits from HIEs, the more rigorous studies such as randomized controlled trials or quasiexperiments were significantly less likely than others to associate HIEs with benefits (Health Affairs, March 2015, Vol. 34:3, pp. 477-483).
Among the six studies considered by the researchers to be the most rigorous, one reported negative effects and three found no effect. In the two studies that reported benefits from HIEs, these effects were largely due to a reduction in diagnostic and imaging tests, associated costs, or both, and these studies were based in a single clinic affiliated with an Indiana hospital or in one healthcare system in Israel, according to the group.
"Furthermore, these two studies had narrower focuses than the others," they wrote. "Overall, little generalizable evidence currently exists regarding benefits attributable to HIE."
In a statement, co-author Nir Menachemi, PhD, said the analysis doesn't conclude that there are no benefits from HIEs, only that "it's simply premature to say if we have or have not gotten our money's worth out of HIE."
Menachemi, now a professor and chair of the department of health policy and management at Indiana University's Fairbanks School of Public Health, was with the University of Alabama when the meta-analysis was performed.
As to why there has been little demonstrated evidence of exchanges' benefits so far, Menachemi noted that HIEs are still in their infancy in the U.S.; most studies have focused on first-generation systems and exchanges in institutions where there isn't much active use. With widespread meaningful use as a result of increasing HIE popularity, researchers may be better able to evaluate HIE adoption.
