No abstract

Repetition of medical services by providers is one of the major sources of healthcare costs. The lack of access to previous medical information on a patient at the point of care often leads a physician to perform medical procedures that have already been done. Multiple healthcare initiatives and legislation at both the federal and state levels have mandated Health Information Exchange (HIE) systems to address this problem. This study aims to assess the extent to which HIE could reduce these repetitions, using data from Centers for Medicare 8 Medicaid Services and a regional HIE organization. A 2-Stage Least Square model is developed to predict the impact of HIE on repetitions of two classes of procedures: diagnostic and therapeutic. The first stage is a predictive analytic model that estimates the duration of tenure of each HIE member-practice. Based on these estimates, the second stage predicts the effect of providers’ HIE tenure on their repetition of medical services. The model incorporates moderating effects of a federal quality assurance program and the complexity of medical procedures with a set of control variables. Our analyses show that a practice's tenure with HIE significantly lowers the repetition of therapeutic medical procedures, while diagnostic procedures are not impacted. The medical reasons for the effects observed in each class of procedures are discussed. The results will inform healthcare policymakers and provide insights on the business models of HIE platforms.

Efforts to promote Health Information Exchanges (HIEs) on a nationwide scale are beset with major challenges, and one of them is its meaningful use for both physicians and patients. Referrals potentially provide a context for the meaningful use of HIE, and we are yet to understand how HIEs affect referrals. This research studies the impact of HIE on referral patterns. We establish that participation in an HIE network increases the referrals sent to and received from other HIE participants. We investigate this relationship using both econometric and network-analytic methods. Whereas the econometric analysis focuses on the underlying associations between HIE adoption and referral patterns, the network analysis addresses the transformation process by which HIE adoption and referrals coevolve over time. This study has significant implications for healthcare policy making, development of innovative HIE business models, and management of healthcare organizations. This paper was accepted by Anindya Ghose, information systems.