Potential value of health information exchange for people with epilepsy: crossover patterns and missing clinical data.

Overview

CONTEXT: For people with epilepsy, the potential value of health information exchange (HIE) is unknown. METHODS: We reviewed two years of clinical encounters for 8055 people with epilepsy from seven Manhattan hospitals. We created network graphs illustrating crossover among these hospitals for multiple encounter types, and calculated a novel metric of care fragmentation: "encounters at risk for missing clinical data." RESULTS: Given two hospitals, a median of 109 [range 46 - 588] patients with epilepsy had visited both. Due to this crossover, recent, relevant clinical data may be missing at the time of care frequently (44.8% of ED encounters, 34.5% inpatient, 24.9% outpatient, and 23.2% radiology). Though a smaller percentage of outpatient encounters were at risk for missing data than ED encounters, the absolute number of outpatient encounters at risk was three times higher (14,579 vs. 5041). CONCLUSION: People with epilepsy may benefit from HIE. Future HIE initiatives should prioritize outpatient access.