Health Information Technology

Physicians support health information exchange but are concerned about paying monthly fees

One of the most significant and promising trends in health care information technology is the emergence of health information exchange (HIE). HIE is the electronic movement of health-related information among organizations according to nationally recognized standards. The benefits ascribed to HIE include increased quality due to better information and reduced costs due to the avoidance of duplicate testing.

A recent survey of 1,043 Massachusetts physicians found that 86 percent felt that HIE will have a positive effect on care quality, 76 percent reported that HIE will have a positive effect on time savings, and 70 percent felt that HIE will have a somewhat or very positive effect on reducing health care costs. However, only slightly more than half (54 percent) of the providers said they would be willing to pay on a monthly basis for access to HIE, and only 37 percent of providers said they would be willing to pay a fee of $150 per month. Physicians in medium-sized practices were more likely to be willing to pay than those in either large or small practices. In general, physicians in medium-sized practices had the most positive attitudes toward HIE, while physicians in large and small practices had less positive attitudes. The researchers suggest that physicians in large practices may already receive some of the benefits of HIE since many of their patients are referred by other physicians in the same practice.

Primary care providers reported more positive attitudes than specialists. This may be a reflection of the differences between providing ongoing care and episodic care, note the researchers. The major unanswered question is how HIE will be financed. Nearly half of the physicians in the survey were unwilling to pay any fee at all. This suggests that HIE business models that rely on large fees paid by providers may face significant challenges. This study was supported by the Agency for Healthcare Research and Quality (HS15397).

See "Physician attitudes toward health information exchange: Results of a statewide survey," by Adam Wright, Ph.D., Christine Soran, Chelsea Jenter, M.P.H., and others in the January/February 2010 Journal of the American Medical Informatics Association 17, pp. 66-70.

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