EHR Market Dominance Affects HIE Use

By Christine Kern, contributing writer

Hospital HIE engagement is associated with vendor dominance, research shows.

According to a study using national data from 2012 and 2013, market dominance of EHR vendors had a significant impact on hospitals’ engagement in health information exchange (HIE). Published by Health Affairs, the report found hospitals using the dominant EHR of their region engaged in an average of 45 percent more HIE activities than those using other vendors, though results varied depending on the level of the vendor’s dominance.

Competition between EHR vendors has become fierce in recent years as customers determine their future purchasing plans. And while EHRs have provided many positive aspects to healthcare such as faster access to patient information, workflow disruptions have also become barriers from realizing better outcomes efficiently, as Health IT Outcomes reported.

While HIE use is intended to improve the quality of care across healthcare organizations by increasing interoperability, many policy makers and members of Congress are worried that some EHR vendors are actually impeding this effort by making cross-vendor HIE difficult. Researchers set out to determine just how vendor domination of the marketplace affected the wide-spread adoption of HIE in a given region. The implications of this study mean that understanding the market’s impact will be vital as policy makers aim to promote cross-vendor HIE, according to the authors.

Perhaps not surprisingly, the bottom line of the study’s finding is that providers who are interested in creating strong HIE connections with other institutions will find it easier to connect with those using a common HER vendor, suggesting that there is incentive to select the dominant local vendor. The downside of this trend is that it can create HIE “islands” that result in limited engagement.

Researchers also noted vendor dominance can be positive even for those using a competitor, since it makes it easier for outsiders to engage in HIE since the cost and complexity of interfacing with a single system are less daunting than those of interfacing with multiple 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.