Electronic Connectivity Among US Hospitals Treating Shared Patients.

Area of Science:

• Health Informatics
• Health Services Research
• Public Health Policy

Background:

• Electronic health information exchange (HIE) is a key policy objective to improve healthcare coordination.
• Various HIE networks, including community, vendor, and national, have been established to facilitate data sharing.
• Understanding the extent of electronic connectivity is crucial for evaluating HIE's impact.

Purpose of the Study:

• To measure electronic connectivity among US hospitals via different HIE networks.
• To identify factors influencing hospital connectivity based on shared patient volume.
• To assess the proportion of shared patients treated by connected hospitals.

Main Methods:

• Cross-sectional analysis of 1721 US acute care hospitals and over 6.4 million shared patients from 2018 data.
• Examined hospital pairs treating at least 11 shared fee-for-service Medicare beneficiaries.
• Defined connectivity based on shared HIE network participation.

Main Results:

• Sixty-four percent of shared patients were treated by hospitals connected through the same HIE network.
• Connectivity varied, with 14% of patients treated by hospitals in different HIE networks and 21% by pairs with only one hospital participating.
• Patients treated by pairs including a for-profit hospital or in competitive markets were less likely to be connected.

Conclusions:

• The majority of shared patients benefit from connected hospitals, but significant opportunities for improved health information exchange exist.
• Connecting disparate HIE networks could enhance overall connectivity.
• Incentivizing participation from hospitals facing competitive concerns may address remaining connectivity gaps.