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Strategic Health Information Exchange Should Focus Outward, Not Inward, Study Suggests

December 22, 2020

Increasing capability for health information exchange increased the proportion of hospital discharges covered by commercial insurers and Medicare, according to a study published online in Health Care Management Review.

However, increasing information sharing within an organization had the opposite effect, researchers found.

“The aim of the study was to identify the impact of hospitals' use of health information exchange capabilities on outcomes that may be sensitive to changes in various contracting arrangements and referral patterns arising from improved connectivity,” wrote Joshua R Vest, PhD, MPH, director of the Center for Health Policy and a professor at Indiana University, and colleagues.

Focusing on a group of community hospitals in nine states between 2010 and 2014, researchers examined the link between the number of different types of data a hospital could exchange and changes in payer mix and other outcomes. 

Expanding health information exchange capability was associated with a 13 percentage point growth in discharges covered by commercial insurers and Medicare, according to the study. Yet increasing intraorganizational information sharing was linked with a 9.6 percentage point drop in discharges covered by commercial insurers and Medicare. 

No associations were found between increasing health information exchange capability or intraorganizational information sharing with increased market share or operating margin.

Researchers concluded that information sharing with outside organizations may be a way to support strategic business goals.

“Organizations may be served by identifying ways to leverage health information exchange instead of focusing on intraorganizational exchange capabilities,” they wrote.

Jolynn Tumolo


Vest JR, Freedman S, Unruh MA, Bako AT, Simon K. Strategic use of health information exchange and market share, payer mix, and operating margins [published online ahead of print, 2020 Dec 8]. Health Care Manage Rev. 2020;10.1097/HMR.0000000000000293. doi:10.1097/HMR.0000000000000293

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