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Health information exchange: participation by Minnesota primary care
practices

Original article by: P Fontaine, T Zink, RG Boyle, J Kralewski

Reference: Archives of Internal Medicine 12 Apr 2010;170(7):622-629

Source: Archives of Internal Medicine

Keywords: Communication-Electronic; Doctors-General Practice; Medical
Records-Electronic; Primary Health Care; United States;

Date published: 16/04/2010 09:13

Summaryby: Pharm-line

Background: The American Recovery and Reinvestment Act of 2009 will
provide US$36 billion to promote electronic health records and the
formation of regional centres that foster community-wide electronic
health information exchange (HIE) with the ultimate goal of a
nationwide health information network. Minnesota's e-Health Law,
passed in 2007, mandates electronic health record and HIE
participation by all clinics and hospitals. To achieve these goals,
small primary care practices must participate. Factors that motivate
or prevent them from doing so are examined.

Methods: From 10 Nov 2008 to 20 Feb 2009, we gathered data (through
questionnaires and interviews) from 9 primary care practices in
Minnesota with fewer than 20 physicians and with varying degrees of
electronic health records and HIE involvement.

Results: No practice was fully involved in a regional HIE, and HIE was
not part of most practices' short-term strategic plans. External
motivators for HIE included state and federal mandates, payer
incentives, and increasing expectations for quality reporting.
Internal motivators were anticipated cost savings, quality, patient
safety, and efficiency. The most frequently cited barriers were lack
of interoperability, cost, lack of buy-in for a shared HIE vision,
security and privacy, and limited technical infrastructure and
support.

Conclusions: Currently, small practices do not have the means or
motivation to fully participate in regional HIEs, but many are
exchanging health data in piecemeal arrangements with stakeholders
with whom they are not directly competing for patients. To achieve
more comprehensive HIE, regional health information organisations must
provide leadership and financial incentives for community-wide
meaningful use of interoperable electronic health records.

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