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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Health information exchange (HIE) is seen as a key component of effective care but remains poorly evidenced at a health system level. In the UK National Health Service (NHS), the ability to share primary care data with secondary care clinicians is a focus of continued digital investment. In this study, we report the evolution of interoperable technology across a period of rapid digital transformation in NHS England from 2015 to 2019, and test association of primary to secondary care data-sharing capabilities with clinical care quality indicators across all acute secondary care providers (<jats:italic>n<\/jats:italic>\u2009=\u2009135 NHS Trusts). In multivariable analyses, data-sharing capabilities are associated with reduction in patients breaching an Accident &amp; Emergency (A&amp;E) 4-h decision time threshold, and better patient-reported experience of acute hospital care quality. Using synthetic control analyses, we estimate mean 2.271% (STD+\/\u22123.371) absolute reduction in A&amp;E 4-h decision time breach, 12 months following introduction of data-sharing capabilities. Our findings support current digital transformation programmes for developing regional HIE networks but highlight the need to focus on implementation factors in addition to technological procurement.<\/jats:p>","DOI":"10.1038\/s41746-023-00891-y","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T11:02:38Z","timestamp":1692010958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of primary to secondary care data sharing on care quality in NHS England hospitals"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6040-2122","authenticated-orcid":false,"given":"Joe","family":"Zhang","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-0672","authenticated-orcid":false,"given":"Hutan","family":"Ashrafian","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3518-0131","authenticated-orcid":false,"given":"Brendan","family":"Delaney","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-7989","authenticated-orcid":false,"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,8,14]]},"reference":[{"key":"891_CR1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1038\/s41746-019-0158-1","volume":"2","author":"M Lehne","year":"2019","unstructured":"Lehne, M., Sass, J., Essenwanger, A., Schepers, J. & Thun, S. 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