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Interstate health-information exchange: understanding value propositions and challenges

Authors LeRouge C, Hirsch J, Feldman S, Bass A

Received 9 July 2015

Accepted for publication 26 January 2016

Published 22 April 2016 Volume 2016:3 Pages 69—77


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Rubin Pillay

Cynthia M LeRouge,1 Joanna L Hirsch,2 Sue S Feldman,3 Angie L Bass4

1Department of Health Services, School of Public Health, University of Washington, Seattle, WA, 2State of Illinois Appellate Judicial System, Collinsville, IL, 3Department of Health Services and Policy Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 4Missouri Health Connection, Columbia, MO, USA

Abstract: Regional intrastate and statewide health-information exchanges help to connect patients' disparate intrastate electronic health records. Intrastate electronic health-information exchange is necessary, yet it does not sufficiently serve the needs of a mobile population, expanding health systems, or a concentration of specialized providers in urban centers serving geographically distant patients. The purpose of this multicase study, consisting of interview data collected from seven states and an intrastate health-information exchange literature review, is to explore the value propositions and challenges for connecting states through interstate exchange. Findings show that attention must be placed on expanding the interstate exchange of patient health data, as 1) many health systems cross state lines, 2) many providers serve patients in different states, and 3) patients are increasingly willing to travel long distances to receive specialized medical attention. An extended discussion contextualizes the findings in consideration of national health-information exchange.

Keywords: direct exchange, query-based exchange, electronic health record

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