Study shows inpatient psychiatric units less likely to use health information exchange

New publication in Health Affairs by Heller PhD candidate Morgan Shields

June 01, 2020

Morgan Shields, PhD candidate

By Hillary Richards, MSc, MA

The June issue of Health Affairs includes a publication led by Heller PhD Candidate Morgan Shields. In the paper, the authors find inpatient psychiatric units in acute care hospitals are less likely to utilize electronic health information exchange (HIE) at discharge. Whereas 88% of acute care hospitals reported use of electronic HIE overall in 2016, only 56.3% of inpatient psychiatric units reported sending health information to providers during the transition of care. 

“Patients of inpatient psychiatry are already a vulnerable population facing many disparities in health care and high rates of comorbidities, including substance use disorder,” says Morgan Shields. “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.”

The article, researched by Shields, Institute for Behavioral Health researcher Grant Ritter, and Harvard Medical School/McLean Hospital researcher Alisa Busch, MD, MS was funded by McLean Hospital and the Brandeis/Harvard NIDA Center to Improve System Performance for Substance Use Disorder Treatment, located in the Institute for Behavioral Health at the Heller School for Social Policy and Management.

Shields et al. found that larger hospitals and those that participate in an accountable care organization were significantly more likely to use electronic HIE in inpatient psychiatric units. Other factors, such as variation in stringency of mental health privacy laws across states, showed no effect on utilization of electronic HIE.

By quantifying the gap between overall use of electronic HIE and use in inpatient psychiatric units 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 particular vulnerable population. “Exchanging health information at discharge to next level of care providers is an important part of health care quality and safety,” says Alisa Busch. “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.”