Health Information Technology

Regional health information exchanges must do more to attract small practices

Health information exchanges (HIEs) allow health care providers in a region to exchange information about patients. A study of small primary care practices in Minnesota found that, unlike hospitals and larger health systems, small practices do not have the means or motivation to participate fully in HIEs. Both the Federal Government and States such as Minnesota have enacted laws in recent years to encourage health care organizations to adopt health information technology such as electronic health records (EHRs) and join regional HIEs.

During 2008 and 2009, when the researchers surveyed nine small practices in the geographic regions served by three established HIEs, they found eight practices using EHRs. Seven of the EHRs were proprietary systems, and the other was developed by the practice using it. All nine practices shared immunization data with the Minnesota Department of Health through a secure, comprehensive Web-based registry. Some form of direct electronic receipt of laboratory information was reported by eight practices. Several of the practices imported lab results from commercial laboratories into their EHR, and one practice had programmed an interface with the hospital laboratory information system. None of the practices reported sharing electronic data with nonaffiliated practices, such as competing primary care groups, specialists, or hospitals. The surveyed practices identified cost and lack of interoperability as key barriers to wider HIE involvement.

The study was funded in part by the Agency for Healthcare Research and Quality (Contract No. 290-07-1001). More details are in "Health Information Exchange. Participation by Minnesota primary care practices," by Patricia Fontaine, M.D., M.S., Therese Zink, M.D., M.P.H., Raymond G. Boyle, Ph.D., M.P.H., and others in the April 12, 2010 Archives of Internal Medicine 170(7), pp. 622-629.

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