Association of Hospital Interoperable Data Sharing With Alternative Payment Model Participation.
Association of Hospital Interoperable Data Sharing With Alternative Payment Model Participation.
复制标题
DOI：
10.1001/jamahealthforum.2021.5199
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Adler-Milstein J
中科院分区：
文献类型：
--
作者：
Holmgren AJ;Everson J;Adler-Milstein J
How much progress did US hospitals make toward building a nationally interoperable health system from 2014 to 2018, and was aligning financial incentives via alternative payment models associated with interoperability? In this cohort study of 3928 US hospitals, progress in interoperability was slow, with fewer than half of hospitals reporting that they engaged in all 4 domains of interoperability by 2018. No evidence of an association between alternative payment model participation and interoperable data sharing was found. The results of this study suggest that building a nationally interoperable health care system remains a complex and challenging task that requires more than just alignment of financial incentives via voluntary payment reform programs. Interoperable patient data exchange across hospitals remains an important policy goal for reducing costs and improving the quality of care. Congress designated 2018 as the goal for nationwide interoperability, and policy makers hoped that aligning financial incentives via alternative payment models (APMs) would help achieve that goal. To measure interoperability progress since 2014, assess the association between alternative payment model participation and hospital engagement in interoperable data sharing from 2014 to 2018, and evaluate hospital-reported barriers to interoperability in 2018. This cohort study included nonfederal acute care hospitals in the US from January 2014 to December 2018 that responded to the American Hospital Association Annual Survey. Data were analyzed from October 2019 through March 2021. Participation in an APM, including accountable care organizations, bundled payments, or patient-centered medical homes. Hospital engagement in all 4 domains of interoperability: finding/querying for data, sending data electronically, receiving data electronically, and integrating electronic patient data from external care delivery organizations. The sample included 3928 hospitals in the US from January 2014 to December 2018. Progress across interoperability domains was uneven, 2430 (88.3%) hospitals sending and 2115 (76.9%) receiving patient data electronically in 2018. However, only 1249 (45.4%) hospitals engaged in all 4 domains of interoperability in 2018, and growth between 2014 and 2018 was slow. There was no evidence that participation in APMs was associated with interoperability, with multivariate models suggesting that participation in an APM was associated with only a non–statistically significant 1–percentage point increase in interoperability engagement (β = 0.01; 95% CI, −0.01 to 0.03). The most commonly cited barrier to interoperability was challenges associated with sharing data across different electronic health record vendors. In this cohort study of hospital interoperability, fewer than half of US hospitals were engaged in interoperable data exchange in 2018. There was no observable evidence that hospital APM participation was associated with interoperability engagement. Many hospitals report technical and governance challenges to data sharing that are unlikely to be addressed by the alignment of financial incentives alone. This cohort study examines interoperability progress, the association between alternative payment model participation and hospital engagement in interoperable data sharing, and hospital-reported barriers to interoperability.
登录
查看更多内容
影响因子：
9.7
作者：
Jha, Ashish K.;DesRoches, Catherine M.;Joshi, Maulik S.
通讯作者：
Joshi, Maulik S.
DOI：
10.1136/amiajnl-2011-000308
发表时间：
2011-09-01
影响因子：
6.4
作者：
Johnson, Kevin B.;Unertl, Kim M.;Frisse, Mark
通讯作者：
Frisse, Mark
在Medicare共享储蓄计划3年后，Medicare支出。
DOI：
10.1056/nejmsa1803388
发表时间：
2018-09-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
McWilliams JM;Hatfield LA;Landon BE;Hamed P;Chernew ME
通讯作者：
Chernew ME
DOI：
10.1136/amiajnl-2013-002449
发表时间：
2014-10-01
影响因子：
6.4
作者：
Everson, Jordan;Lee, Shoou-Yih D.;Friedman, Charles P.
通讯作者：
Friedman, Charles P.
影响因子：
6.3
作者：
Callaway, Brantly;Sant'Anna, Pedro H. C.
通讯作者：
Sant'Anna, Pedro H. C.