{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T01:55:35Z","timestamp":1768269335996,"version":"3.49.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:00:00Z","timestamp":1609632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000092","name":"National Library of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T15LM012502"],"award-info":[{"award-number":["T15LM012502"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the practice- and market-level factors associated with the amount of provider health information exchange (HIE) use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Provider and practice-level data was drawn from the Meaningful Use Stage 2 Public Use Files from the Centers for Medicare and Medicaid Services, the Physician Compare National Downloadable File, and the Compendium of US Health Systems, among other sources. We analyzed the relationship between provider HIE use and practice and market factors using multivariable linear regression and compared primary care providers (PCPs) to non-PCPs. Provider volume of HIE use is measured as the percentage of referrals sent with electronic summaries of care (eSCR) reported by eligible providers attesting to the Meaningful Use electronic health record (EHR) incentive program in 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Providers used HIE in 49% of referrals; PCPs used HIE in fewer referrals (43%) than non-PCPs (57%). Provider use of products from EHR vendors was negatively related to HIE use, while use of Athenahealth and Greenway Health products were positively related to HIE use. Providers treating, on average, older patients and greater proportions of patients with diabetes used HIE for more referrals. Health system membership, market concentration, and state HIE consent policy were unrelated to provider HIE use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>HIE use during referrals is low among office-based providers with the capability for exchange, especially PCPs. Practice-level factors were more commonly associated with greater levels of HIE use than market-level factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This furthers the understanding that market forces, like competition, may be related to HIE adoption decisions but are less important for use once adoption has occurred.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocab024","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T04:21:35Z","timestamp":1612326095000},"page":"1451-1460","source":"Crossref","is-referenced-by-count":13,"title":["Practice and market factors associated with provider volume of health information exchange"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7775-8544","authenticated-orcid":false,"given":"Nate C","family":"Apathy","sequence":"first","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Regenstrief Institute, Indianapolis, Indiana, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7226-9688","authenticated-orcid":false,"given":"Joshua R","family":"Vest","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Indianapolis, Indiana, USA"},{"name":"Health Policy & Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA"}]},{"given":"Julia","family":"Adler-Milstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California, USA"}]},{"given":"Justin","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Health Policy & Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1121-0607","authenticated-orcid":false,"given":"Brian E","family":"Dixon","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Indianapolis, Indiana, USA"},{"name":"Health Policy & Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA"}]},{"given":"Christopher A","family":"Harle","sequence":"additional","affiliation":[{"name":"Regenstrief Institute, Indianapolis, Indiana, USA"},{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA"}]}],"member":"286","published-online":{"date-parts":[[2021,1,3]]},"reference":[{"key":"2021071421214848200_ocab024-B1","author":"Verma","year":"2018"},{"issue":"1","key":"2021071421214848200_ocab024-B2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.hjdsi.2018.08.004","article-title":"Practice strategies to improve primary care for chronic disease patients under a pay-for-value program","volume":"7","author":"Cross","year":"2019","journal-title":"Healthc (Amst)"},{"key":"2021071421214848200_ocab024-B3","first-page":"e1","article-title":"Alternative payment models and hospital engagement in health information exchange","volume":"25","author":"Lin","year":"2019","journal-title":"Am J Manag Care"},{"key":"2021071421214848200_ocab024-B4","doi-asserted-by":"crossref","first-page":"W5-10","DOI":"10.1377\/hlthaff.W5.10","article-title":"The value of health care information exchange and interoperability","volume":"24 (Suppl1","author":"Walker","year":"2005","journal-title":"Health Aff"},{"issue":"3","key":"2021071421214848200_ocab024-B5","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1136\/jamia.2010.003673","article-title":"Health information exchange: persistent challenges and new strategies","volume":"17","author":"Vest","year":"2010","journal-title":"J Am Med Inform Assoc"},{"key":"2021071421214848200_ocab024-B6","author":"Adler-Milstein","year":"2017"},{"key":"2021071421214848200_ocab024-B7","author":"Myrick","year":"2017"},{"key":"2021071421214848200_ocab024-B8","author":"Patel","year":"2019"},{"issue":"2","key":"2021071421214848200_ocab024-B9","doi-asserted-by":"crossref","first-page":"e12607","DOI":"10.2196\/12607","article-title":"Interoperable electronic health records and health information exchanges: systematic review","volume":"7","author":"Dobrow","year":"2019","journal-title":"JMIR Med Inform"},{"issue":"9","key":"2021071421214848200_ocab024-B10","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1093\/jamia\/ocy035","article-title":"The benefits of health information exchange: an updated systematic review","volume":"25","author":"Menachemi","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2021071421214848200_ocab024-B11","doi-asserted-by":"crossref","first-page":"3285","DOI":"10.1111\/1475-6773.12838","article-title":"Technology, incentives, or both? 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