Health information exchange (HIE) is seen as an essential technology for improving health care quality and efficiency by allowing exchange of patient-centered data over time and across organizations. The objective of this study was to evaluate the usage and the perceived usefulness of a nationwide HIE in a centralized model that was implemented in 2013 in the province of Quebec, Canada. A mixed-method study was conducted with a longitudinal descriptive analysis of usage data combined with in-depth comparative case study in four selected primary care organizations and two emergency departments. Perceived benefits were reported by users across all dimensions of care performance, including accessibility, efficiency, quality and safety, and patient experience; however, the experience of users was very heterogeneous and strongly associated with the commercial electronic record system available in their work place and the implementation strategy.
Keywords: Electronic Health Records; Health Information Exchange; Quality of Health Care.