More research is needed to understand the overall impact of health information exchanges (HIEs), according to a RAND study published in the Annals of Internal Medicine.

The researchers sought to systematically review and evaluate evidence on the use and effect of HIEs on clinical care. Specifically, they analyzed data—including hypothesis-testing or quantitative studies of several types of data exchange in clinical environments—from Jan. 1, 2003 to May 31, 2014. The focus was on how HIEs impact health outcomes, efficiency, utilization, costs, satisfaction, HIE usage, sustainability and attitudes or barriers.

The study found:

• Low-quality evidence from 12 hypothesis-testing studies supporting HIE use to reduce use or costs in the emergency department.
• Provider usage was less than 10 percent of patient encounters for 13 HIE organizations, 6 of which were located in New York.
• Approximately one quarter of existing HIE organizations consider themselves financially stable, according to findings from 17 studies.
• Findings from 38 studies about attitudes and barriers showed that providers, patients and other stakeholders see HIEs as valuable, but barriers include technical and workflow issues, costs and privacy concerns.

RAND researchers noted that HIE use probably reduces emergency department usage and costs, but effects on other outcomes remain unknown. As such, more research is necessary to understand success factors associated with HIE utilization.