Health information exchange, Health Information Technology use, and hospital readmission rates

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 offers significant financial incentives to hospitals that can demonstrate "meaningful use" of EHRs. Reduced hospital readmissions are an expected outcome of improved care coordination. Increased use of HIT, and in particular participation in HIE are touted as ways to improve coordination of care. In a 2007 national sample of US hospitals, we evaluated the association between hospitals' HIE and HIT use and 30-day risk adjusted readmission rates for acute myocardial infarction (AMI), heart failure, and pneumonia. We found that hospital participation in HIE was not associated with lower hospital readmission rates; however, high levels of electronic documentation (an aspect of HIT use) were associated with modest reductions in readmission for heart failure (24.6% vs. 24.1%, P=.02) and pneumonia (18.4% vs. 17.9%, P=.003). More detailed data on participation in HIE are necessary to conduct more robust assessment of the relationship between HIE and hospital readmission rates.