How does Health Information Exchange Technology Affect Patients’ Care Seeking? Perspective from Continuity of Care

Patients with chronic diseases often face a trade-off between maintaining continuity of care (CoC) and finding a more appropriate healthcare provider, which is critical to their health outcomes. However, fragmented healthcare systems can limit patients’ options and flexibility in seeking care. Health information exchanges (HIEs) offer a potential solution by providing seamless data exchange channels for healthcare providers. Employing a Markovian score model, we analyze diabetes patient outpatient visit histories from 99 hospitals in New York State. Applying both difference-in-differences (DID) and instrumental variables (IV) approaches, our results consistently indicate that HIE adoption facilitates patient switching behavior. Our heterogeneous analysis provides evidence that the reduction in patient retention is greater for rural hospitals and for patients who live far from the hospital. These findings suggest that HIEs can improve patient flexibility in seeking care, but may exacerbate geospatial disparities, necessitating stakeholders to seek a balanced approach when implementing HIEs.