EHR Market Dominance Can Influence HIE Usage

16684482_lDive Brief:

  • A new analysis of national data from 2012 and 2013 has revealed how market dominance of EHR vendors impacted hospitals’ engagement in health information exchange (HIE).
  • The study published in Health Affairs found hospitals using the dominant EHR of their region engaged in an average of 45% more HIE activities than those using other vendors, though results varied depending on the level of the vendor’s dominance.
  • Understanding the market’s impact will be vital as policy makers aim to promote cross-vendor HIE, the authors argued.

Dive Insight:

Much of the analysis boils down to the finding that providers interested in establishing strong HIE connections will find it easier to do so with others using the same EHR vendor, suggesting there is incentive to go with the dominant local player — though that can leave HIE “islands” that still result in limited engagement.

The researchers added that in markets with low vendor dominance, hospitals may engage in less HIE with hospitals using other systems compared to markets with high vendor dominance due to high costs and competitive barriers. “Policies designed to promote cross-vendor HIE may need to take local market competition into account,” they found.

The analysis also points to an upside to vendor dominance even for those using a competitor. Greater dominance in a market can make it easier for outsiders to engage in HIE because the cost and complexity of interfacing with one dominant system are less than those of interfacing with numerous smaller systems.

“In markets with low vendor dominance, the cost of hospital engagement in HIE with multiple vendors’ systems may be prohibitive, and vendors may be less interested in collaborating because competition is stronger,” the study found.


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