Why GAO did this study. Widespread adoption of electronic health information exchange has the potential to improve health care quality and reduce costs. While these goals have been pursued for years, they have proved challenging to realize. Through the HITECH Act, the federal government provided $2.4 billion to states to improve and advance certain aspects of electronic health information exchange. In light of this federal investment, GAO was asked to review health information exchange. This report describes (1) states’ use of the HITECH funding for health information exchange efforts and their plans to replace those funds, (2) the extent to which use of electronic health information exchange has changed since the enactment of the HITECH Act, and (3) federal efforts that aim to address challenges to electronic health information exchange. GAO reviewed information and interviewed officials from ONC and the Centers for Medicare & Medicaid Services, the agency that administered the HITECH funding. GAO also conducted interviews with state agencies in eight states selected based on geographic variation and whether states accessed the HITECH funding for health information exchange, among other factors. In addition, GAO analyzed hospital and physician survey data, and interviewed a range of stakeholders, including physicians and organizations representing physicians, as well as organizations representing hospitals, payers, health information exchange organizations, and other industry representatives.
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