Push and pull: physician usage of and satisfaction with health information exchange

Federal policy toward health information exchange (HIE), the electronic transfer of patient data across organizations, has evolved to support two forms-push, or point-to-point data transmission, and pull, or multisource data aggregation. HIE usage is associated with user satisfaction, but existing quantitative research is limited to settings where only pull HIE is available. To address this gap, we surveyed 99 physicians regarding usage of and satisfaction with push HIE and pull HIE available in their communities as well as effects of HIE on practice and overall HIE satisfaction. In five of nine measures, respondents reported being very satisfied with push HIE more often than pull HIE (p < 0.05). Physicians were at least four times as likely to report being very satisfied with HIE overall if they were pediatricians, were very satisfied with push HIE, or noted that HIE improved their access to complete information. Findings have implications for HIE implementation and policy.