{"doi":"10.1093/jamia/ocz116","title":"Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Objective</jats:title>\n                  <jats:p>Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods</jats:title>\n                  <jats:p>The association between unplanned 30-day readmissions among adult patients and adoption of enterprise HIE or a single vendor environment was measured in a panel of 211 system-member hospitals from 2010 through 2014 using fixed-effects regression models. Sample hospitals were members of health systems in 7 states. Enterprise HIE was defined as self-reported ability to exchange information with other members of the same health system who used different EHR vendors. A single EHR vendor environment reported exchanging information with other health system members, but all using the same EHR vendor.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Enterprise HIE adoption was more common among the study sample than EHR (75% vs 24%). However, adoption of a single EHR vendor environment was associated with a 0.8% reduction in the probability of a readmission within 30 days of discharge. The estimated impact of adopting an enterprise HIE strategy on readmissions was smaller and not statically significant.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion</jats:title>\n                  <jats:p>Reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggests that HIE technologies can better support the aim of higher quality care. Additionally, health systems may benefit more from a single vendor environment approach than attempting to foster exchange across multiple EHR vendors.</jats:p>\n               </jats:sec>","journal":"Journal of the American Medical Informatics Association","year":2019,"id":608162,"datarank":0.48283137373023016,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"self_citation_contribution":0.48283137373023016,"citation_network_contribution":0.0,"self_endowment_contribution":0.48283137373023016,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":330673,"name":"Mark Aaron Unruh","orcid":"0000-0002-9662-5659","position":1,"is_corresponding":false},{"id":1110776,"name":"Seth Freedman","orcid":"0000-0002-4081-3239","position":2,"is_corresponding":false},{"id":433490,"name":"Kosali Simon","orcid":"0000-0002-3231-1466","position":3,"is_corresponding":false},{"id":441931,"name":"Joshua R. Vest","orcid":"0000-0002-7226-9688","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Objective</jats:title>\n                  <jats:p>Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods</jats:title>\n                  <jats:p>The association between unplanned 30-day readmissions among adult patients and adoption of enterprise HIE or a single vendor environment was measured in a panel of 211 system-member hospitals from 2010 through 2014 using fixed-effects regression models. Sample hospitals were members of health systems in 7 states. Enterprise HIE was defined as self-reported ability to exchange information with other members of the same health system who used different EHR vendors. A single EHR vendor environment reported exchanging information with other health system members, but all using the same EHR vendor.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Enterprise HIE adoption was more common among the study sample than EHR (75% vs 24%). However, adoption of a single EHR vendor environment was associated with a 0.8% reduction in the probability of a readmission within 30 days of discharge. The estimated impact of adopting an enterprise HIE strategy on readmissions was smaller and not statically significant.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion</jats:title>\n                  <jats:p>Reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggests that HIE technologies can better support the aim of higher quality care. Additionally, health systems may benefit more from a single vendor environment approach than attempting to foster exchange across multiple EHR vendors.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"31348514","pmcid":"PMC7792753","openalex_id":"https://openalex.org/W2965213801","authors":[],"funders":[{"funder_name":"Agency for Healthcare Research & Quality","grant_id":"1R21HS024717-01A1","title":null},{"funder_name":"AHRQ HHS","grant_id":"R21 HS024717","title":null},{"funder_name":"NIH","grant_id":"","title":null}],"total_grants":3,"fwci":2.8291,"citation_percentile":0.92077728,"influential_citations":0,"citation_trend":[{"year":2020,"count":1},{"year":2021,"count":1},{"year":2022,"count":7},{"year":2023,"count":6},{"year":2024,"count":5},{"year":2025,"count":3},{"year":2026,"count":1}],"oa_status":"green","license":"https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model","oa_locations":[{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7792753","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7792753","host_type":"repository"},{"url":"http://academic.oup.com/jamia/article-pdf/26/10/989/34152213/ocz116.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/jamia/ocz116","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/31348514","host_type":"repository"},{"url":"http://europepmc.org/pmc/articles/PMC7792753","host_type":"repository"},{"url":"https://hdl.handle.net/1805/28922","host_type":"repository"}],"fields_of_study":["Electronic Health Records Systems","Heart Failure Treatment and Management","Healthcare Policy and Management"],"mesh_terms":["Adult","Aged","Aged, 80 and over","Commerce","Delivery of Health Care","Female","Hospital Administration","Hospitals","Humans","Longitudinal Studies","Male","Middle Aged","Patient Readmission","United States","Organizational Policy","Electronic Health Records","Health Information Exchange"],"keywords":["Vendor","Health information exchange","Electronic health record","Quality (philosophy)","Health information technology","Health care","Sample (material)","Information exchange","Operations management","Business","Medicine","Health information","Marketing","Computer science","Telecommunications","Engineering","Hospitals","Electronic Health Records","Patient Readmission Policy"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-30T07:35:35.939544Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}