More Physicians Exchanging Electronic Data

Ken Terry

October 28, 2016

About a third of physicians electronically sent, received, integrated, or searched for patient information in 2015, according to a new report from the Centers for Disease Control and Prevention (CDC). When compared to data from an earlier report in Health Affairs and a survey by the Office of the National Coordinator for Health IT (ONC), the new figures suggest that health information exchange among physicians grew significantly in comparison with previous years.

In 2015, the CDC survey of 10,300 physicians found that the percentages of doctors who had electronically sent data to or received data from outside providers were about the same — 38.2% and 38.3%, respectively. Those figures represent nearly half of the 78% of physicians who utilized electronic health records (EHRs) in that year.

Thirty-one percent of the respondents had electronically integrated the outside data into their EHRs, meaning they had not manually entered or scanned the date into their systems. Thirty-four percent of the physicians had electronically searched for patient information from sources outside their organization. Those searches usually occurred when a physician was seeing a new patient or an established patient who had been seen by another provider.

The Health Affairs report shows that health information exchange among physicians was significantly lower in 2013 than in 2015. Although 39% of responding doctors said they electronically shared data with other providers, only 14% exchanged data with ambulatory care providers or hospitals outside their healthcare organization.

In 2014, according to the ONC report, 26% of physicians electronically shared patient health information with ambulatory care providers outside their office or group. About the same percentage of doctors shared data with hospitals, but fewer than 1 in 10 shared information with hospitals with which they were not affiliated.

The 2015 CDC report uncovered large variations in the degree of health information exchange across the country. For example, the percentage of physicians who sent data electronically to other providers was only 19.4% in Idaho, about half the national average, but it was 56.3% in Arizona. Similarly, the percentage of physicians who electronically integrated information from other providers ranged from 18.4% in Alaska to 49.3% in Delaware.

The survey question on electronic data integration asked specifically about 10 different types of health information: medication and allergy lists, patient problem lists, imaging reports, laboratory results, registry data, referrals, hospital discharge summaries, emergency department notifications, and summary-of-care records for transitions of care or referrals. Physicians who answered "yes" on at least one of these data types were classified as having electronically integrated information.

Electronic integration did not mean that data were incorporated into the discrete fields of EHRs. Electronic documents such as care summaries or discharge summaries that went into the EHR as PDF files would have counted for this purpose.

There are three main methods for physicians to exchange data electronically with practices or hospitals outside their healthcare organizations. They can use a public health information exchange (HIE), Direct Secure Messaging, or a proprietary EHR exchange platform such as Epic Everywhere. Other services that provide interoperability include CommonWell Health Alliance, CareQuality, and Surescripts, but no reliable data exist on how many providers are using those services.

An often-cited report showed that 10% of ambulatory care practices used public HIEs, but that report dates from 2012, and no comparable surveys have been done since then.

DirectTrust, a trade association of companies that provide the infrastructure for Direct Secure Messaging, released on Wednesday the latest figures on the use of that vehicle for information sharing. At the end of the third quarter, more than 69,000 healthcare organizations were served by health information service providers belonging to DirectTrust. This represents a 62% increase from the prior year. There were nearly 22 million DirectTrust exchange transactions in the third quarter, an increase of 64% over the same period a year earlier.

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