Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug;32(1):184-194.
doi: 10.1055/s-0043-1768719. Epub 2023 Jul 6.

Health Information Exchange: Understanding the Policy Landscape and Future of Data Interoperability

Affiliations
Review

Health Information Exchange: Understanding the Policy Landscape and Future of Data Interoperability

A Jay Holmgren et al. Yearb Med Inform. 2023 Aug.

Abstract

Objectives: To review recent literature on health information exchange (HIE), focusing on the policy approach of five case study nations: the United States of America, the United Kingdom, Germany, Israel, and Portugal, as well as synthesize lessons learned across countries and provide recommendations for future research.

Methods: A narrative review of each nation's HIE policy frameworks, current state, and future HIE strategy.

Results: Key themes that emerged include the importance of both central decision-making as well as local innovation, the multiple and complex challenges of broad HIE adoption, and the varying role of HIE across different national health system structures.

Conclusion: HIE is an increasingly important capability and policy priority as electronic health record (EHR) adoption becomes more common and care delivery is increasingly digitized. While all five case study nations have adopted some level of HIE, there are significant differences across their level of data sharing infrastructure and maturity, and each nation took a different policy approach. While identifying generalizable strategies across disparate international systems is challenging, there are several common themes across successful HIE policy frameworks, such as the importance of central government prioritization of data sharing. Finally, we make several recommendations for future research to expand the breadth and depth of the literature on HIE and guide future decision-making by policymakers and practitioners.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Table 1
Table 1
Dimensions of Health Information Exchange Across Five Nations.

References

    1. Adler-Milstein J, Jha AK. HITECH Act drove large gains in hospital electronic health record adoption. Health Aff (Millwood)2017;36(8):1416–22. doi: 10.1377/hlthaff.2016.1651. - PubMed
    1. Blumenthal D. Stimulating the Adoption of Health Information Technology. N Engl J Med 2009;360(15):14779. doi: 10.1056/NEJMp0901592. - PubMed
    1. Walker J, Pan E, Johnston D, Adler-Milstein J, Bates DW, Middleton B. The value of Health care information exchange and interoperability. Health Aff (Millwood) 2005;Suppl Web Exclusives:W5-10-W5-18. doi: 10.1377/hlthaff.w5.10. - PubMed
    1. Kyle MA, Frakt AB. Patient administrative burden in the US health care system. Health Serv Res 2012;56(5):755–65. doi: 10.1111/1475-6773.13861. - PMC - PubMed
    1. Holmgren AJ, Apathy NC, Adler-Milstein J. Barriers to Hospital Electronic Public Health Reporting and Implications for the COVID-19 Pandemic. J Am Med Inform Assoc 2020;27(8):1306-9. doi: 10.1093/jamia/ocaa112. - PMC - PubMed