Journal of Health & Medical Informatics

Background: Health information exchange (HIE) programs as a policy subject in several developed countries can enable information sharing across providers and healthcare organizations to improve care coordination. However, besides the expected benefits of participating in HIE in enhancing coordination, reducing costs, and improving patient safety, previous studies report that clinicians' rate of using HIE mechanisms is still low. Insufficient participation of clinicians in data exchange networks can diminish the value of HIE. Based on utility theory, this study aims to identify and categorize barriers associated with the implementation of HIE projects in healthcare organizations and develop a comprehensive model to empirically examine the effects of HIE inhibitors on clinicians' intention to engage in HIE networks.

Methods: Data was collected using an online survey from 318 clinicians working in different healthcare settings in the United States.

Results: Results show that internal inhibitors (including technological and organizational barriers) and external inhibitors (including partners, patients, vendors, and legal barriers) strongly influence clinicians' intention to engage in HIEs. Taking an integrated approach, this study can contribute to the existing literature by providing a more informed way of conceptualizing and explaining HIE adoption in healthcare organizations.

Conclusion: The findings can help HIE decision-makers, healthcare organizations, and providers to identify key HIE inhibitors and take corrective actions to address them. Addressing both internal and external inhibitors would increase the likelihood of widespread implementation of HIEs in different healthcare settings and facilitate interoperability and connectivity in regional and community health information networks.