Physicians' Experiences of Health Information Exchange in Finland After Ten Years of National Patient Data Repository Services

Health information exchange (HIE) is expected to improve cross-organizational collaboration and access to data. In Finland, the first regional health information systems (RHISs) were introduced in 2003, and the electronic prescription and national patient data repository ("Kanta") services were implemented in 2010-17. We explored physicians' experiences and use of cross-organizational HIE at four time points: before (2010) and after the implementation of the prescription center (2014), and after the full implementation of Kanta (2017), and during established use (2021). The data were retrieved from four large national cross-sectional usability-focused surveys targeted for physicians and analyzed by physician specialty groups and study years. Across all specialties, RHISs and Kanta Services had largely replaced the need for paper/fax-based HIE. The experiences of medication information, or health information system support for collaboration between physicians working in different organizations improved only slightly during the study period suggesting that availability of medication information and patient documentation are not sufficient for adequate HIE services when most HIE is of "pull" type.