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Researchers at McLean Hospital and Brandeis University have found that inpatient psychiatric programs in acute care hospitals are less likely to utilize electronic health information exchange (HIE) at discharge. Electronic HIE is a cost-effective method for improving the speed, quality, and safety of patient care.
According to their paper published in a recent issue of Health Affairs, 88% of acute care hospitals reported the use of electronic HIE overall at discharge in 2016 while only 56.3% of inpatient psychiatric units reported sending health information to providers during the transition of care. By quantifying the gap between overall use of electronic HIE and use in inpatient psychiatric programs in particular, the researchers show the importance of promoting the uptake of electronic HIE in inpatient psychiatric units and improving communication during transitions of care for this particularly vulnerable population.
“Exchanging health information at discharge to next level of care providers is an important part of health care quality and safety,” said Alisa Busch, MD, MS, director of the Clinical Performance Measurement & Health Services Research program at McLean Hospital. “Finding this disparity in HIE among patients being discharged from inpatient psychiatric care is concerning and highlights the need for more robust health policy efforts to correct this disparity by incentivizing the use of health information technology in psychiatric care settings.”
“Patients of inpatient psychiatry units are already a vulnerable population facing many disparities in health care and high rates of coexisting conditions, including substance use disorder,” added Morgan Shields, a PhD candidate at Brandeis University’s Heller School for Social Policy and Management. “Our research brings to light a structural disparity in showing that, even within acute care hospital settings utilizing electronic health information exchange, use of HIE within the psychiatric units lags behind.”
Busch and colleagues found that larger hospitals and those that participate in an accountable care organization were significantly more likely to use electronic HIE in inpatient psychiatric programs. Other factors, such as variation in the stringency of mental health privacy laws across states, showed no effect on the use of electronic HIE.
The article, researched by Busch, Shields, and Grant A. Ritter, PhD, associate professor at the Heller School for Social Policy and Management, was funded by McLean Hospital and the Brandeis/Harvard NIDA Center to Improve System Performance for Substance Use Disorder Treatment.