Barriers to Health Information Exchange Among Ambulatory Physicians: Results From a Nationally Representative Sample

Purpose: Health information exchange (HIE) improves healthcare quality, but is underutilized by providers. This study used a nationally representative survey of ambulatory physicians to examine barriers to HIE, and identify which barriers have the greatest impact on providers’ use of HIE. Methods: A pooled sample of 1,292 physicians from the 2018–2019 National Electronic Health Record Survey was used. Univariate statistics described rates and patterns of eight common barriers to HIE. Multivariate logistic regression examined the relationship between each barrier and the use of HIE. Results: Barriers to HIE were common and diverse. Negative attitudes toward HIE’s ability to improve clinical quality significantly decreased HIE use (OR = .44, p < .01). Conclusions: To increase adoption of HIE, efforts should focus on addressing providers’ negative attitudes toward HIE. These findings can guide targeted implementation strategies to improve HIE adoption.