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The full impact of electronic health information exchange on patient outcomes has not been adequately studied, according to a new  from the Agency for Healthcare Research and Quality. While studies show more than three-quarters of U.S. hospitals electronically exchanged laboratory results, radiology reports, clinical care summaries and/or medication lists with outside providers in 2014, an 85% increase since 2008, only 39% of office-based physicians could electronically exchange health information with other providers or hospitals in 2012, the report found. Based on a review of available research, the authors found that barriers to HIE include challenges getting a critical mass of participants, inefficient workflow, and poorly designed interface and update features. Most of the studies were retrospective and reported on narrow questions rather than overall clinical and financial impacts, the authors said. Information was insufficient to allow an assessment of usability by HIE function or architecture. “To advance our understanding of HIE, future studies need to address comprehensive questions, use more rigorous designs, and be part of a coordinated systematic approach to studying HIE,” the report states.