“Implementation and effective use of health information exchanges (HIEs)—systems that electronically share clinical and administrative data between settings of care—has the
potential to transform health care and improve patient out-comes. Financial investments in HIE infrastructure and the achievement of a critical mass of hospitals and health systems
participating in information sharing have mitigated key structural barriers to HIE use, while technological innovations, including the incorporation of HIE into electronic health records (EHRs), have improved integration of HIEs into many clinicians’ workflows. However, real-world use of HIE is lagging: it is estimated that HIEs are accessed in less than 20% of
clinical encounters and in only 50% of referrals—despite being a part of required reporting for the Centers for Medicare and Medicaid Services Promoting Interoperability incentive
program. Health information exchange use varies widely across settings of care: as few as 3.7% of outpatient visits and 17.6% of inpatient admissions recorded HIE use in one study.”

“This study provides an updated reflection of the current barriers and facilitators to HIE system adoption and use in a major healthcare market and highlights potential opportunities for interventions leveraging an implementation science approach to improve information exchange and address existing barriers. While many improvements would likely require high-level policy changes to increase technological support for HIE and reduce financial barriers to implementation, possible system or end-user interventions include creating customizable HIE interfaces to improve usability and uptake, such as those that can be created with Fast Healthcare Interoperability Resources technologies. Many of these
findings are likely transferable to similar contexts in other states. Our findings suggest that the HIE landscape in Atlanta has improved, and that health systems and clinicians appreciate the value of HIE platforms to support patient care. However, despite most hospitals and health systems participating in HIE systems, there remain numerous challenges that diminish the potential impact of HIE, which will require additional research and policies to understand and address.”

Turbow, S. D., Vaughan, C. P., Ali, M. K., Clevenger, C. K., & Perkins, M. M. (2026). Better than nothing, far from perfect: hospital and healthcare system leaders’ perspectives on health information exchanges. JAMIA open, 9(1), ooaf178.