Assessing the value of health information exchange organizations to hospital interoperability.

Introduction: Various federal efforts have supported the development of local, regional, and state health information exchange organizations (HIOs), a type of network that promotes secure electronic exchange of patient health information among hospitals, healthcare providers, community-based organizations, and public health authorities. With the emergence of complementary and alternative modes to facilitate exchange, we sought to assess the value of HIOs to hospital interoperability.

Methods: We leveraged nationally representative survey data from a unique linked dataset of N  = 2200 hospitals linked to HIOs to examine the relationship between hospitals' engagement in a range of interoperability activities and participation in an HIO that offers services to support those activities.

Results: We found that hospital participation in an HIO was significantly associated with greater engagement in clinical information exchange, public health reporting, and health-related social needs information exchange. However, among hospitals participating in an HIO, we did not find strong evidence of a relationship between specific HIO capabilities or services and hospital engagement in exchange.

Conclusion: Our findings indicate HIOs offer a useful avenue for exchange but are only one path through which exchange takes place as there are various alternatives available to support interoperability activities.