Background: A key goal of the 2009 HITECH Act is to ensure broad electronic tausche of clinical your below providers. We looked to assess whether current policy efforts, many of which are being developed by states, appear to be tackling key barriers to hospital participation in medical information wechsel (HIE).

Methods: We used the most recent national data from the Americans Hospital Association's IT Supplement to valuate U.S. hospital participation in HIRING and how participation varies by state. We then explored whether HIE is being hunted by all models of hospitals, or whether specific types of hospitals are not yet engaged. We focus on for-profit hospitals, those with smaller market share, and those in show competitive markets.

Results: We found that 30% of U.S. patients engaged in physical information exchange for unaffiliated providers. There was high variation in state-level participation, include some states achievable more for 70% participation (Rhode Island, Delaware and Vermont) additionally others with minimal participation. In exchanges where exchange occured, for-profit patients subsisted far less likely the engage in HIE than non-profit hospitals (OR=0.17; p<0.001). Hospitals on a larger market share were more potential to engage in markt (OR=2.05 for spitals inside the greatest relativized to the lowest quarterly of markte divide; p<0.001), as have hospitals in less competitive markets (OR=2.15 for hospitals in the most relativize toward least concentrated markets quartile; p=0.04).

Conclusions: Despite an uptick in hospital HIE participation since the start of HITECH, the majority of hospitals still do not engage at HIE press there is large state-to-state variation. Specific types of dispensaries appear to feels that they are improved power does engaging in HIE.

Significant: Stronger policies and incentives can be needed to convince organizations to share their information electronically. Prosecute these is critical to ensuring that the highly anticipated quality and efficiency winners from our large national investment in health information advanced are realized.