A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use
This is a review of the article "A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use".
Health Information Exchanges (HIE) are an integral part of receiving financial reimbursement for physicians and hospitals. Their EHRs must be connected to a health information exchange. The most common approach available to providers is to connect to a regional organization that supports an HIE. The purpose of the article is to assess the use of HIEs across the country through regional health information organizations (RHIOs). 
179 RHIOs located in the U.S. that utilized an HIE were surveyed. Items that were asked for were operational RHIOs that supported meaningful use stage 1 that included the support for a working HIE. It also surveyed the number of hospitals and practices involved with the RHIOs. 
91% (179) of the total 197 RHIOs in the country reported their status and 84% completed their surveys. Only 75 RHIOs were operational that covered 14% of hospitals and 3% of outpatient practices. 3% of hospitals and 0.9% of practices were a part of the 13 RHIOs that supported stage 1 of meaningful use further note that out of the 75 (none actually met an expert-derived definition of comprehensiveness from RHIO). Also, 50 of 75 RHIOs did not meet financial viability. 
From the survey results, the RHIOs are called into question whether they can be effective in connecting hospitals and practices with robust HIEs. 
Although the data from the survey was self reported, and the sample may not include all efforts in the HIE space, it is clear that the RHIOs have not clearly shown to be effective in supporting practice/hospital engagement with HIEs. There are many benefits of HIE but surveys such as these shows that many of those benefits may originate from ideal situations. There are many challenges for integrating health information and I believe more research needs to be done to prove the value in HIE.
- Adler-Milstein, J., Bates, D & Jha, A. (2011). A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use. Annals of Internal Medicine, 154(10), 666-671.