Despite the plethora of studies that highlight the benefits of health information exchanges (HIEs), a new Indiana-Purdue University research paper uncovered that there actually isn’t much evidence that HIE improves speed, quality, safety and the cost of patient care. The paper was published in the journal Health Affairs.

The researchers analyzed 27 HIE benefit studies and searched for evidence that HIEs improve efficiency, bring down costs and lead to better outcomes. They found that there was “no strong documented evidence in the studies that health care benefits are directly attributed to the use of HIE.”

"There is a dearth of rigorous studies that link HIE adoption to clear benefits,” according to the paper. “Moreover, the scant high-quality evidence that does exist was conducted in disparate settings and evaluated different outcomes.”
Additionally, the studies that aimed to identify casual relationships, mostly only found benefits when it came to health care cost measures. Two out of six of those studies, which were conducted in a single clinic affiliated with an Indiana hospital and a health care system in Israel, found that the decline in health care costs were due to a decrease in diagnostic and imaging tests.

One of the issues that has to be ironed out is whether the connection between computerization and better outcomes is really due to the fact that early adopters of HIEs are the among the top health care providers.

The researchers still anticipate HIEs to bring about benefits in the future, but so far no one has proven in a “general and convincing” manner that those benefits can be expected. That could be because HIEs in the U.S. are still at an early stage.

Many of the studies evaluated first-generation systems and exchanges in institutions where they’re not actively used. When HIEs are more commonly used and meaningful use is more prevalent, researchers may be able to better evaluate adoption.

Nir Menachemi, one of the authors of the paper, is hoping to conduct a study like that in Central Indiana, which has the most mature HIE system in the country, according to the report. Menachemi said there is a "huge opportunity to generate evidence of HIE benefits using more rigorous studies than have been done in the past."

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