Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

Joshua R. Vest, Mark Aaron Unruh, Seth Freedman, Kosali Simon

Research output: Contribution to journalArticle


Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. Materials and Methods: The association between unplanned 30-day readmissions among adult patients and adoption of enterprise HIE or a single vendor environment was measured in a panel of 211 system-member hospitals from 2010 through 2014 using fixed-effects regression models. Sample hospitals were members of health systems in 7 states. Enterprise HIE was defined as self-reported ability to exchange information with other members of the same health system who used different EHR vendors. A single EHR vendor environment reported exchanging information with other health system members, but all using the same EHR vendor. Results: Enterprise HIE adoption was more common among the study sample than EHR (75% vs 24%). However, adoption of a single EHR vendor environment was associated with a 0.8% reduction in the probability of a readmission within 30 days of discharge. The estimated impact of adopting an enterprise HIE strategy on readmissions was smaller and not statically significant. Conclusion: Reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggests that HIE technologies can better support the aim of higher quality care. Additionally, health systems may benefit more from a single vendor environment approach than attempting to foster exchange across multiple EHR vendors.

Original languageEnglish (US)
Pages (from-to)989-998
Number of pages10
JournalJournal of the American Medical Informatics Association
Issue number10
StatePublished - Jun 24 2019



  • electronic health records
  • health information exchange
  • hospitals
  • patient readmission policy

ASJC Scopus subject areas

  • Health Informatics

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