How Do You Define Regional? The Geography of Health Information Exchange
Project Final Report (PDF, 482.38 KB) Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
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Project Details -
Completed
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Grant NumberR03 HS020304
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AHRQ Funded Amount$100,000
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Principal Investigator(s)
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Organization
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LocationNew York CityNew York
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Project Dates09/01/2013 - 12/31/2015
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Health Care Theme
Multiple organizations facilitate health information exchange (HIE) activity in the United States. Community health information organizations (HIOs) historically have provided exchange services for a geographically defined community, such as a region or a State. Estimates suggest that there are 200 national community HIOs, but their potential benefits are generally unknown. Through a series of related studies, this project sought to clarify the concept of geographical area that is fundamental to HIE activity, and explored the practical and policy implications of how exchange service areas are defined and measured.
The specific aims of the project were as follows:
- Describe the extent of community HIO activity in the U.S.
- Use healthcare markets to better define community HIO exchange activity.
- Examine the implications of how leaders of HIE organizations and healthcare organizations define exchange service areas.
- Contrast the benefits and challenges of community HIOs with those of enterprise HIE, a non-geographically defined approach to exchange activity organization.
The researchers conducted three distinct but related geographical and qualitative investigations. First, geographical information systems (GIS) analyses were utilized to identify and quantify the extent of community HIO activity. Next, a qualitative GIS analysis built on these findings to explore how healthcare organizations and policymakers defined community HIO market areas. Finally, a qualitative analysis compared the barriers and enablers of a community HIO strategy with a non-geographically based HIE strategy.
The mapping analyses indicated gaps in community HIO activity and overlapping community HIO efforts. Findings showed that geography is not an effective organizing principle. Qualitative interviews and data suggested that the role of geography is changing. Specifically, organizing HIE activities along defined geographies is becoming less important and less practical.
Citation: Vest JR. Geography of community health information organization activity in the United States: implications for the effectiveness of health information exchange. Health Care Manage Rev 2017 Apr/Jun;42(2):132-41. PMID: 26982490.
Principal Investigator: Vest, Joshua Ryan
Document Type: Journal Publication
Research Method: Current State Assessment, Mixed Methods
Technology: Geographic Information System, Health Information Exchange
Citation: Vest JR, Kash BA. Differing strategies to meet information-sharing needs: publicly supported community health information exchanges versus health systems' enterprise health information exchanges. Milbank Q 2016 Mar;94(1):77-108. PMID: 26994710.
Principal Investigator: Vest, Joshua Ryan
Document Type: Journal Publication
Research Method: Qualitative, Structured/Semi-Structured Interview
Technology: Dashboard, Health Information Exchange
Population: Administrator, C-Suite Officer, Decisionmaker
Citation: Vest, J. How Do You Define Regional? The Geography of Health Information Exchange - Final Report. (Prepared by Weill Medical College of Cornell University under Grant No. R03 HS020304). Rockville, MD: Agency for Healthcare Research and Quality, 2015.
Link:
r03hs020304-vest-final-report-2015.pdf
(482.38 KB)
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
Principal Investigator: Vest, Joshua Ryan
Document Type: Report
Technology: Health Information Exchange
Disclaimer
Disclaimer details