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

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

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: 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 : JAMIA
Volume26
Issue number10
DOIs
StatePublished - Oct 1 2019

Fingerprint

Electronic Health Records
Health
Quality of Health Care
Health Information Exchange
Medical Informatics

Keywords

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

ASJC Scopus subject areas

  • Health Informatics

Cite this

Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions. / Vest, Joshua; Unruh, Mark Aaron; Freedman, Seth; Simon, Kosali.

In: Journal of the American Medical Informatics Association : JAMIA, Vol. 26, No. 10, 01.10.2019, p. 989-998.

Research output: Contribution to journalArticle

@article{1086001a069149b9aacbaa7b997db75f,
title = "Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions",
abstract = "OBJECTIVE: 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.",
keywords = "electronic health records, health information exchange, hospitals, patient readmission policy",
author = "Joshua Vest and Unruh, {Mark Aaron} and Seth Freedman and Kosali Simon",
year = "2019",
month = "10",
day = "1",
doi = "10.1093/jamia/ocz116",
language = "English (US)",
volume = "26",
pages = "989--998",
journal = "Journal of the American Medical Informatics Association : JAMIA",
issn = "1067-5027",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

AU - Vest, Joshua

AU - Unruh, Mark Aaron

AU - Freedman, Seth

AU - Simon, Kosali

PY - 2019/10/1

Y1 - 2019/10/1

N2 - OBJECTIVE: 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.

AB - OBJECTIVE: 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.

KW - electronic health records

KW - health information exchange

KW - hospitals

KW - patient readmission policy

UR - http://www.scopus.com/inward/record.url?scp=85072363068&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072363068&partnerID=8YFLogxK

U2 - 10.1093/jamia/ocz116

DO - 10.1093/jamia/ocz116

M3 - Article

C2 - 31348514

AN - SCOPUS:85072363068

VL - 26

SP - 989

EP - 998

JO - Journal of the American Medical Informatics Association : JAMIA

JF - Journal of the American Medical Informatics Association : JAMIA

SN - 1067-5027

IS - 10

ER -