Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange

Joshua Vest, Kosali Simon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: U.S. policy on interoperable HIT has focused on increasing inter-system (ie, between different organizations) health information exchange. However, interoperable HIT also supports the movement of information within the same organization (ie, intra-system exchange). Methods: We examined the relationship between hospitals' intra-and inter-system information exchange capabilities among health system hospitals included in the 2010-2014 American Hospital Association's Annual Health Information Technology Survey. We described the factors associated with hospitals that adopted more intra-system than inter-system exchange capability, and explored the extent of new capability adoption among hospitals that reported neither intra-or inter-system information capabilities at baseline. Results: The prevalence of exchange increased over time, but the adoption of inter-system information exchange was slower; when hospitals adopt information exchange, adoption of intra-system exchange was more common. On average during our study period, hospitals could share 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange. Controlling for other factors, hospitals exchanged more types of information in an intra-system manner than inter-system when the number of different inpatient EHR vendors in use in health system is larger. Conclusion: Consistent with the U.S. goals for more widely accessible patient information, hospitals' ability to share information has increased over time. However, hospitals are prioritizing within-organizational information exchange over exchange between different organizations. If increasing inter-system exchanges is a desired goal, current market incentives and government policies may be insufficient to overcome hospitals' motivations for pursuing an intra-system-information-exchange-first strategy.

Original languageEnglish (US)
Pages (from-to)1189-1196
Number of pages8
JournalJournal of the American Medical Informatics Association
Volume25
Issue number9
DOIs
StatePublished - Jan 1 2018

Fingerprint

Information Systems
Organizations
Motivation
American Hospital Association
Medical Informatics
Aptitude
Health
Inpatients

Keywords

  • health information exchange
  • hospitals
  • medical informatics
  • policy

ASJC Scopus subject areas

  • Health Informatics

Cite this

@article{8aa41a61a800440a8fa2d070da9e026e,
title = "Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange",
abstract = "Introduction: U.S. policy on interoperable HIT has focused on increasing inter-system (ie, between different organizations) health information exchange. However, interoperable HIT also supports the movement of information within the same organization (ie, intra-system exchange). Methods: We examined the relationship between hospitals' intra-and inter-system information exchange capabilities among health system hospitals included in the 2010-2014 American Hospital Association's Annual Health Information Technology Survey. We described the factors associated with hospitals that adopted more intra-system than inter-system exchange capability, and explored the extent of new capability adoption among hospitals that reported neither intra-or inter-system information capabilities at baseline. Results: The prevalence of exchange increased over time, but the adoption of inter-system information exchange was slower; when hospitals adopt information exchange, adoption of intra-system exchange was more common. On average during our study period, hospitals could share 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange. Controlling for other factors, hospitals exchanged more types of information in an intra-system manner than inter-system when the number of different inpatient EHR vendors in use in health system is larger. Conclusion: Consistent with the U.S. goals for more widely accessible patient information, hospitals' ability to share information has increased over time. However, hospitals are prioritizing within-organizational information exchange over exchange between different organizations. If increasing inter-system exchanges is a desired goal, current market incentives and government policies may be insufficient to overcome hospitals' motivations for pursuing an intra-system-information-exchange-first strategy.",
keywords = "health information exchange, hospitals, medical informatics, policy",
author = "Joshua Vest and Kosali Simon",
year = "2018",
month = "1",
day = "1",
doi = "10.1093/jamia/ocy058",
language = "English (US)",
volume = "25",
pages = "1189--1196",
journal = "Journal of the American Medical Informatics Association : JAMIA",
issn = "1067-5027",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange

AU - Vest, Joshua

AU - Simon, Kosali

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: U.S. policy on interoperable HIT has focused on increasing inter-system (ie, between different organizations) health information exchange. However, interoperable HIT also supports the movement of information within the same organization (ie, intra-system exchange). Methods: We examined the relationship between hospitals' intra-and inter-system information exchange capabilities among health system hospitals included in the 2010-2014 American Hospital Association's Annual Health Information Technology Survey. We described the factors associated with hospitals that adopted more intra-system than inter-system exchange capability, and explored the extent of new capability adoption among hospitals that reported neither intra-or inter-system information capabilities at baseline. Results: The prevalence of exchange increased over time, but the adoption of inter-system information exchange was slower; when hospitals adopt information exchange, adoption of intra-system exchange was more common. On average during our study period, hospitals could share 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange. Controlling for other factors, hospitals exchanged more types of information in an intra-system manner than inter-system when the number of different inpatient EHR vendors in use in health system is larger. Conclusion: Consistent with the U.S. goals for more widely accessible patient information, hospitals' ability to share information has increased over time. However, hospitals are prioritizing within-organizational information exchange over exchange between different organizations. If increasing inter-system exchanges is a desired goal, current market incentives and government policies may be insufficient to overcome hospitals' motivations for pursuing an intra-system-information-exchange-first strategy.

AB - Introduction: U.S. policy on interoperable HIT has focused on increasing inter-system (ie, between different organizations) health information exchange. However, interoperable HIT also supports the movement of information within the same organization (ie, intra-system exchange). Methods: We examined the relationship between hospitals' intra-and inter-system information exchange capabilities among health system hospitals included in the 2010-2014 American Hospital Association's Annual Health Information Technology Survey. We described the factors associated with hospitals that adopted more intra-system than inter-system exchange capability, and explored the extent of new capability adoption among hospitals that reported neither intra-or inter-system information capabilities at baseline. Results: The prevalence of exchange increased over time, but the adoption of inter-system information exchange was slower; when hospitals adopt information exchange, adoption of intra-system exchange was more common. On average during our study period, hospitals could share 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange. Controlling for other factors, hospitals exchanged more types of information in an intra-system manner than inter-system when the number of different inpatient EHR vendors in use in health system is larger. Conclusion: Consistent with the U.S. goals for more widely accessible patient information, hospitals' ability to share information has increased over time. However, hospitals are prioritizing within-organizational information exchange over exchange between different organizations. If increasing inter-system exchanges is a desired goal, current market incentives and government policies may be insufficient to overcome hospitals' motivations for pursuing an intra-system-information-exchange-first strategy.

KW - health information exchange

KW - hospitals

KW - medical informatics

KW - policy

UR - http://www.scopus.com/inward/record.url?scp=85055081844&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055081844&partnerID=8YFLogxK

U2 - 10.1093/jamia/ocy058

DO - 10.1093/jamia/ocy058

M3 - Article

VL - 25

SP - 1189

EP - 1196

JO - Journal of the American Medical Informatics Association : JAMIA

JF - Journal of the American Medical Informatics Association : JAMIA

SN - 1067-5027

IS - 9

ER -