Over the last several years, I’ve read many a report on physicians’ sharing of health data. The key metrics most observers use to measure these efforts are how often physicians send and receive data and what type of data they’re sending.
I’m not so sure that this measurement offers the best look at health data sharing. I’m more interested in what doctors do with the information than what they shared and received. My guess is that these reports measure PHI coming and going because it’s simply more practical and does offer at least some insight.
In that spirit, I present to you some numbers from the CDC’s National Health Statistics Reports. That data comes from the 2015 National Electronic Health Records Survey, a nationally-representative survey of nonfederal office-based physicians. The study estimates the types PHI doctors electronically sent, searched for, received and integrated.
Survey results included the following:
- Among physicians who sent PHI electronically, the most common types of data sent were referrals (67.9%), laboratory results (67.2%) and medication lists (65.1%). The least commonly observed types were summary of care records (51.5%), registry data (55.9%) and imaging reports (56.6%).
- When these physicians received PHI, the most common types the study found were laboratory results (78.8%), imaging (60.8%) and medication lists (54.4%). The types seen least often included ED notifications (34.5%), hospital discharge summaries (42.5%) and registry data (43.2%).
- For physicians who integrated PHI electronically, the most commonly observed types were laboratory results (73.2%), imaging reports (49.8%) and hospital discharge summaries (48.7%). PHI least commonly integrated included registry data (30.9%), problem lists (32.7%) and medication allergy lists (36.1%).
- The most common reasons physicians searched for PHI electronically were to find medication lists (90.2%), medication allergy lists (88.2%) and hospital discharge summaries (80.4%), followed by imaging reports (58.9%), laboratory results (48.5%) and problem lists (41.2%).
The CDC analysis of this data notes that it might be smart to articulate the differences between primary care PHI exchange and specialist PHI exchange. It rightfully points out that research which breaks down such data not only by specialty, but also office setting, practice size and EHR vendor would be a good idea.
These aren’t the only issues left unaddressed, though. What strikes me about this data is that there’s little symmetry between what doctors send and what they receive. There’s also little overlap between the sharing stats and those regarding what they integrate. Their priorities when searching for information seem to be on their own track as well.
What does this mean? It’s hard to tell. But I think someone should look at the differences in how doctors participate in various forms of electronic exchange of PHI. These differences probably say something, and it would be nice to know what it is.