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- Title
The associations between query-based and directed health information exchange with potentially avoidable use of health care services.
- Authors
Vest, Joshua R.; Unruh, Mark Aaron; Shapiro, Jason S.; Casalino, Lawrence P.
- Abstract
<bold>Objective: </bold>To quantify the impact of two approaches (directed and query-based) to health information exchange (HIE) on potentially avoidable use of health care services.<bold>Data Sources/study Setting: </bold>Data on ambulatory care providers' adoption of HIE were merged with Medicare fee-for-service claims from 2008 to 2014. Providers were from 13 counties in New York served by the Rochester Regional Health Information Organization (RHIO).<bold>Study Design: </bold>Linear regression models with provider and year fixed effects were used to estimate changes in the probability of utilization outcomes for Medicare beneficiaries attributed to providers adopting directed and/or query-based HIE compared with beneficiaries attributed to providers who had not adopted HIE.<bold>Data Collection: </bold>Providers' HIE adoption status was determined through Rochester RHIO registration records. RHIO and claims data were linked via National Provider Identifiers.<bold>Principal Findings: </bold>Query-based HIE adoption was associated with a 0.2 percentage point reduction in the probability of an ambulatory care sensitive hospitalization and a 1.1 percentage point decrease in the likelihood of an unplanned readmission. Directed HIE adoption was not associated with any outcome.<bold>Conclusions: </bold>The Centers for Medicare & Medicaid Services' (CMS) EHR certification criteria includes requirements for directed HIE, but not query-based HIE. Pending further research, certification criteria should place equal weight on facilitating query-based and directed exchange.
- Subjects
NEW York (State); UNITED States; HEALTH information exchanges; MEDICAL care use; MEDICAL care; MEDICAL informatics; MEDICAID beneficiaries; OUTPATIENT medical care; ELECTRONIC data interchange standards; HOSPITAL statistics; COMMUNICATION; ELECTRONIC data interchange; HOSPITALS; INFORMATION retrieval; MEDICARE; RESEARCH funding
- Publication
Health Services Research, 2019, Vol 54, Issue 5, p981
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13169