Table 2.

Benefits and Barriers to Participation of Primary Care Practices in Health Information Exchanges

Themes	Examples
Benefits
More efficient workflow	Less time spent handling laboratory results Improved access to clinical data Streamlined referral processes
Improved quality of care	Better health outcomes Improved patient safety, including (1) fewer prescribing errors and (2) fewer hospital readmissions
Cost savings	Eliminating costs of storing paper records Downsizing personnel
Increased revenue	Government incentives for use of health IT Pay-for-performance incentives
Barriers
Cost	Costs of EHR implementation Cost of establishing and maintaining links between EHRs and HIE networks
Security and privacy issues	Patients and providers concerned about privacy of PHI in an electronic environment
Liability	Provider's concern to be held liable for information from outside sources/labs
Leadership, strategic planning, and competition	Lack of strategic plan for health IT Misaligned incentives (who pays and who benefits) Provider reluctance to relinquish control of patient information to competing systems
Technical barriers	Lack of interoperability among EHRs Lack of IT training and support

IT, information technology; EHR, electronic health record; HIE, health information exchange; PHI, personal health information.