{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T22:37:10Z","timestamp":1746571030886},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"funder":[{"name":"Agency for Healthcare Quality & Research","award":["R21HS024717-01A1"],"award-info":[{"award-number":["R21HS024717-01A1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>U.S. policy on interoperable HIT has focused on increasing inter-system (ie, between different organizations) health information exchange. However, interoperable HIT also supports the movement of information within the same organization (ie, intra-system exchange).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We examined the relationship between hospitals\u2019 intra- and inter-system information exchange capabilities among health system hospitals included in the 2010-2014 American Hospital Association\u2019s Annual Health Information Technology Survey. We described the factors associated with hospitals that adopted more intra-system than inter-system exchange capability, and explored the extent of new capability adoption among hospitals that reported neither intra- or inter-system information capabilities at baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of exchange increased over time, but the adoption of inter-system information exchange was slower; when hospitals adopt information exchange, adoption of intra-system exchange was more common. On average during our study period, hospitals could share 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange. Controlling for other factors, hospitals exchanged more types of information in an intra-system manner than inter-system when the number of different inpatient EHR vendors in use in health system is larger.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Consistent with the U.S. goals for more widely accessible patient information, hospitals\u2019 ability to share information has increased over time. However, hospitals are prioritizing within-organizational information exchange over exchange between different organizations. If increasing inter-system exchanges is a desired goal, current market incentives and government policies may be insufficient to overcome hospitals\u2019 motivations for pursuing an intra-system-information-exchange-first strategy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocy058","type":"journal-article","created":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T19:07:33Z","timestamp":1527016053000},"page":"1189-1196","source":"Crossref","is-referenced-by-count":16,"title":["Hospitals\u2019 adoption of intra-system information exchange is negatively associated with inter-system information exchange"],"prefix":"10.1093","volume":"25","author":[{"given":"Joshua R","family":"Vest","sequence":"first","affiliation":[{"name":"Indiana University Richard M. 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