Is There a Link Between New Practice Models, HIE Usage?

Is there a connection between participation in a value-based care model and increased use of a health information exchange? Research based on a survey of Arizona physicians found that compared with physicians in traditional care delivery models, physicians in ACOs and clinically integrated networks had significantly higher odds of using HIE to share both patient care summaries and laboratory results.

A paper published this month in the American Journal of Managed Care by J. Mac McCullough, Ph.D., M.P.H., and Chad Stecher, Ph.D., examined associations between the use of emerging practice models and the use of HIE. They looked at survey data came from more than 3,000 Arizona physicians in 2019-2021.

The researchers wrote that they found a strong but not deterministic relationship between ACO/CIN/IDN participation and HIE use. Odds of HIE use for patient summaries or laboratory results increased by roughly 50 percent to 100 percent for providers in ACOs or integrated care models. They added, however, that the relationship was not absolute, “meaning that although many ACO and integrated care model providers used HIE, some did not.”

“We identify notable areas for future study and policy attention where providers are participating in either HIE or ACO/CIN/IDN models but not both.”

They also found patterns in barriers to use of HIE between ACO/CIN/IDN-participating providers and nonparticipating providers, including demographic and practice characteristics and differential self-reported barriers to future adoption and use of HIE.

The researchers also examined barriers to HIE usage. Despite having higher odds of using HIE, ACO physicians were significantly more likely to report a lack of connectivity with other providers and a lack of information from other providers as barriers to using HIE than were physicians in traditional care delivery models, the researchers found.

In addition, physicians in group or private practice were “significantly more likely to report concerns over confidentiality than were physicians in community clinics. Additionally, physicians in Maricopa County (which contains Phoenix and is largely an urban county) were less likely to report a lack of connectivity as a barrier to HIE.”

In conclusion, the researchers suggest that nuances in associations between ACO/CIN/IDN participation and use of HIE suggest a persistence of previously identified HIE gaps, and the barriers cited provide guidance for increasing HIE use among different practice types.