- The division of the Centers for Disease Control and Prevention (CDC) recently published a data brief on variation in physician office health data exchange by state in 2015.
According to its authors, approximately one-third of office-based physicians had sent, received, integrated, or searched for patient health information electronically over the previous year. Less than one-tenth (8.7%) had performed all form electronic health data exchange capabilities.
As Eric W. Jamoom, PhD, MPH, MS, and Ninee Yang, PhD, noted in the introduction to the NCHS data brief, 77.9 percent of office-based physicians had certified EHR technology in practices in 2015 — up from 74.1 percent in 2014.
The data of electronic information sharing reveal that high level of CEHRT adoption levels do not equate to similarly high levels of health data exchange. What’s more, the ability of these physicians to exchange health data varies by state by sharing functionality.
The national average for electronically sending patient health information to other providers reached 38.2 percent in 2015. At the high end of spectrum was Arizona (56.3%); at the low end, Idaho (19.4%). Other states falling below the national average were Connecticut (22.7%) and New Jersey (24.3%).
As for the ability to receive patient health information from other providers electronically, the most capable state was Wisconsin (65.5%). Meanwhile, Arizona (40.6) was much closer to the national average of 38.3 percent for this category. Three other states were statistically significantly greater than the average — Oregon (59.2%), Minnesota (55.0%), and Massachusetts (52.9%). Bringing up the rear for being statistically significantly less than the national average were Alabama (24.3%), Missouri (24.2%), Louisiana (23.6%), and Mississippi (23.6%).
As with the ability to send patient health information to other providers, a very small number of states had scores statistically significantly higher than the national average (31.3%) for being able to integrate patient health information from other providers — Delaware (49.3%) and Indiana (44.2%). Alabama (18.8%) and Idaho (20.6%) once again featured among states with statistically significantly lower scores along with Montana (18.6%).
The ability to search for patient health information from other providers had many standout states. Ten states reported percentages statistically significantly greater than the national average of 34.0 percent:
- Oregon (61.2%)
- Washington (58.0%)
- Wisconsin (54.1%)
- Delaware (53.9%)
- North Carolina (48.8%)
- Virginia (48.3%)
- Maryland (47.9%)
- Colorado (47.5%)
- Alaska (47.3%)
- Ohio (47.2%)
Meanwhile, five states and territories reported percentages statistically significantly less than the national average:
- District of Columbia (15.1%),
- Mississippi (19.7%)
- Pennsylvania (20.8%)
- Texas (21.0%)
- Missouri (21.6%)
- Oklahoma (22.8%)
The NCHS report using 2015 National Electronic Health Records is consistent with findings published by the Office of the National Coordinator for Health Information Technology on non-federal acute care hospital health data exchange capabilities. The latter were based on data from the 2014-2015 American Hospital Association Survey Information Technology Supplement.
While the ONC data brief on hospital health data exchange capabilities was not segmented by state, it did provide insight into how hospitals of different sizes and in different settings fared across the four domains outlined above.
The data revealed disparities between small and medium-to-large hospitals, critical access and non-critical access hospitals, and rural and suburban and urban hospitals. In almost all instances, bigger and more urban were better able to perform the four health data exchange capabilities.
The authors of the ONC data brief concluded that worked needing to be done to address variation in health data exchange capabilities.
“In summary, progress has been made over the last year with regards to interoperability across hospitals nationwide,” they wrote. “However, monitoring variation in interoperability by hospital and area characteristics is critical to ensuring that all hospitals are engaging in the core domains of interoperability so that information from outside providers are electronically available at the point of care and are used to inform clinical decisions.”
A similar conclusion could be drawn from the NCHS data brief on physician office health data exchange, which not only varies between states but also lags behind hospitals as a whole.