HIE use results in fewer hospitalizations, cost savings

Using a health information exchange system may reduce hospitalizations from the emergency department and save money, according to a new study from Weill Cornell Medical College published this week in Applied Clinical Informatics.

As outlined in an announcement from Cornell, emergency department physicians are less likely to admit patients to the hospital when they have readily available electronic access to those patients' health records.

"New York State has made significant investments in health information exchange," Joshua Vest, M.D., an assistant professor at Weill Cornell and the study's lead author, said in the announcement. "Our study shows that providing physicians, nurses and allied healthcare professionals such as physician assistants real-time access to community-wide, longitudinal health records does in fact benefit patients."

The study identified 15,645 adults living in New York who had visited the ED during a six-month period, all of whom agreed to have their information uploaded to the state's HIE. Using claims from the patients' health plans, the researchers determined whether the ED visit was then followed by admission to the hospital.

The HIE system was used for 2.4 percent of ED encounters, and the odds of hospital admission were 30 percent lower when it was accessed. In the sample, annual savings amounted to $357,000.

"Emergency department physicians need to treat patients every day, even when they don't have complete medical information on those patients," Ted Kremer, executive director of the Rochester Regional Health Information Organization, which implemented the technology used in the study, said in the announcement. "This study suggests that providing physicians with more clinical information helps prevent hospital admissions." 

The Rochester RHIO combines all patient recent and historical medical information from local providers. Using the HIE allows ED physicians to realize, for example, an abnormal electrocardiogram reading is baseline for a patient, instead of something that would prompt hospitalization.

Last December, research published in Health Affairs determined that data from HIEs more accurately identifies patients who visit EDs frequently than a single site's records.

The HIE data revealed 20.3 percent more frequent ED users and 16 percent more visits by them to the ED that site-specific records. It also found that 28.8 percent of frequent ED users visited multiple EDs during the 12-month study period, versus 3 percent of all ED users.

To learn more:
- see the study abstract
- read the announcement from Cornell

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