Dive Brief:
- The benefits and cost savings attributed to the use of HIEs have not been clearly identified by the bulk of research on such exchanges, according to a new study published by Health Affairs.
- The study, performed by researchers at the University of Alabama at Birmingham, Weill Cornell Medical College and Indiana University, scrutinized 27 articles that contained 94 individual analyses of HIE usage in patient care. While researchers agreed that 57% of the analyses reflected some form of benefit, they also pointed out that only six of the articles included a model with strong internal validity such as randomized controlled trials or quasi-experiments.
- The overall conclusion of the study was that the assumption that HIEs provide cost savings and patient care benefits was not strongly supported by the body of research on the topic that exists today.
Dive Insight:
More or less since their commercial inception, policymakers, providers and payers alike have taken it on faith that sharing data between providers would lead to significant cost and quality benefits. While the current HealthAffairs study doesn't rule this assumption out, it does make a strong case that there's little to back it up as of yet.
It's worth noting, however, that there probably isn’t enough critical mass in any part of the nation to say definitively whether the HIE model is actually working or not, according to University of Minnesota researcher Lisa Moon. So the HealthAffairs conclusions may be premature.
What's more, defining what an HIE should be has taken roughly a decade, and the concept continues to evolve as mobile device data enters the picture, population health management becomes a priority and interoperability experiments keep evolving. It may be that researchers won't be able to draw definitive conclusions about HIEs until the model settles down further.