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Potential Unintended Consequences of Health Information Exchange


Accountable models of care delivery demand that health care provider organizations be able to exchange clinical data about the patient. The “Meaningful Use” program is helping to advance health information exchange by requiring physicians and hospitals to exchange clinical data about patients in order to qualify for incentive payments for electronic health records. Early studies demonstrate that the ability to exchange clinical data among provider organizations has the potential to improve clinical care. However, as with any technology, there is a risk of unintended consequences from health information exchange. This manuscript outlines seven aspects of health information exchange that, if not managed properly, may lead to unintended consequences. These categories are: (1) the desire for complete, accurate and timely data for decision making, (2) data management and presentation, (3) assuring routine use of health information exchange, (4) consideration of patient perceptions and concerns, (5) reputational and financial concerns, (6) technical issues and (7) administrative aspects of health information exchange. Education about the capabilities and limitations of health information exchange, along with checklists to support proper implementation and assure that systems are being used as planned, can mitigate risks and help to realize the promise of this powerful technology.

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Dr. Kuperman and Dr. McGowan are supported in part by Task Order HHSP23337003T from Westat under Contract HHSP23320095655WC from the Office of the National Coordinator for Health Information Technology.


We gratefully acknowledge the contributions of the other participants in the Health Information Exchange Unintended Consequences Workgroup.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Corresponding author

Correspondence to Gilad J. Kuperman MD, PhD.

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Kuperman, G.J., McGowan, J.J. Potential Unintended Consequences of Health Information Exchange. J GEN INTERN MED 28, 1663–1666 (2013).

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  • medical informatics
  • continuity of care
  • technology assessment