Colorado now has clear, peer-reviewed evidence that health information exchange (HIE) participation achieves its intended goals: improved patient outcomes, reduced costs, and improved clinical and administrative efficiency.
A new study published in the Journal of Clinical Medicine—conducted by the Center for Improving Value in Health Care (CIVHC) and sponsored by Contexture—took a detailed look at how provider HIE use affects patient utilization. The analysis focused on real claims data from the Colorado All-Payer Claims Database (CO APCD), covering a period before COVID-19 upended healthcare use patterns.
The takeaway is straightforward: clinics that use HIE services see better patient results. That impact is most pronounced for patients with Medicaid plans, but the trend holds across all payer types.
Why This Study Matters
For years, the health information exchange industry has talked about the value of HIEs. What's been harder to come by is rigorous, claims-based evidence that quantifies the benefits.
Researchers compared data on more than 42,000 patients, including those seen at clinics with access to Contexture's HIE services and those seen at similar clinics that had not yet subscribed. Because they looked at a clean, pre-COVID window (2017–2019), they were able to isolate the impact of HIE participation without pandemic-related swings in care use.
What they found backs up what providers have experienced anecdotally: when clinicians can quickly access a patient's history—including tests, notes, imaging, and medications—they're able to make better decisions and help patients avoid unnecessary, high-cost care.
Key Findings
- Emergency Department utilization rates looked very different between facilities connected to Contexture and the control group that was not:
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- Clinics using integrated HIE + EHR tools saw an 11% drop in ED visits vs. unconnected control clinics that saw an 18.5% increase
- Growth in inpatient admission rates looked dramatically different depending on whether facilities were integrated with Contexture:
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- Clinics with HIE integration saw a 22.2% increase in inpatient admissions
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- Clinics without HIE integration saw a 62% increase
Across all insurance types, HIE participation was associated with slower growth in emergency and inpatient utilization.
Additionally, clinics using HIE services experienced easier care coordination and reduced administrative burdens, with healthcare providers reporting streamlined access to outside test results and patient histories.
These differences add up. Emergency and inpatient care are among the most expensive services in healthcare, and preventing even a fraction of those visits can have a major downstream impact on cost savings and patient well-being.
Crucial Takeaways for Providers and Policymakers
The study lands at a moment when nearly every part of the health system is trying to do more with less. Providers face workforce shortages and rising administrative demands. Payers are looking for ways to control spending without reducing access. Policymakers are evaluating major investments in health IT modernization.
Evidence like this helps clarify where those investments can make the greatest difference.
The findings also arrive as CMS launches the $50 billion Rural Health Transformation Program, which allows states to use federal funds to strengthen health IT infrastructure, including HIE services, provider notifications, and EHR integration. For many rural and safety-net providers, these tools can be game-changers.
This study measured utilization rather than dollars, but the financial implications are clear: avoiding unnecessary emergency visits and inpatient stays translates to lower costs.
Contexture is already developing more detailed ROI modeling tools that will help quantify the financial return providers and payers can expect from Contexture HIE participation. As those models evolve, they'll build directly on the utilization patterns identified in this study.
Colorado's Leadership Role
By supporting and publishing this study, Colorado has taken a meaningful step toward establishing an evidence base for HIE value. It gives providers, payers, and state leaders something solid to point to as they plan for the future of care coordination and health data modernization.
And it reinforces a simple truth: for years, providers shared stories about the benefits. Now the evidence confirms it: when providers can see the full picture, patients get better care.
Click here to read the full study, "Impact of Provider Health Information Exchange Services on Patient Utilization of Emergency Room and Inpatient Practices in Colorado" published in the Journal of Clinical Medicine (November 2025).
