Impact of Health Information Exchange Adoption on Referral Patterns

Efforts to promote Health Information Exchanges (HIEs) on a nationwide scale are beset with major challenges, and one of them is its meaningful use for both physicians and patients. Referrals potentially provide a context for the meaningful use of HIE, and we are yet to understand how HIEs affect referrals. This research studies the impact of HIE on referral patterns. We establish that participation in an HIE network increases the referrals sent to and received from other HIE participants. We investigate this relationship using both econometric and network-analytic methods. Whereas the econometric analysis focuses on the underlying associations between HIE adoption and referral patterns, the network analysis addresses the transformation process by which HIE adoption and referrals coevolve over time. This study has significant implications for healthcare policy making, development of innovative HIE business models, and management of healthcare organizations.