Study links HIE use to less imaging in the ER

Use of a health information exchange helped curb repeat imaging tests for headache patients who went to Memphis emergency departments, but didn't cut overall costs, according to a recent study.

Researchers from the University of Tennessee Health Science Center studied 1,252 adults who made at least two visits to Memphis ERs between 2007 and 2009. Patient records were shared through an HIE connecting 15 major hospitals and two regional clinic systems. Cases in which HIE records were used were compared with those that were not and the use of neuroimaging tests including CT, CT angiography, MRI or MRI angiography.

Though there was little difference in overall costs, the subjects for whom HIE records were available were less likely to undergo repeat diagnostic neuroimaging and more likely to be treated through evidence-based guidelines, according to the study, published in the Journal of General Internal Medicine.

The authors called for more information to determine whether specific HIE enhancements could further reduce potentially unnecessary imaging, improve adherence with care guidelines and still reduce costs.

At least one of the researchers, Mark Frisse, was part of a Vanderbilt team that last year reported that the sharing of electronic data among 12 Memphis-area EDs saved nearly $2 million over 13 months by reducing hospital admissions and redundant imaging tests.

It's a theory to be tested in Washington state this summer. The Washington State Health Care Authority, which is working with the Washington State Hospital Association and other physicians on the effort, estimates that such sharing will result in $31 million in savings.

So far, hospital and physician participation in HIEs is low, but a big burst of spending on HIEs is expected by 2014. As the proposed Meaningful Use Stage 2 regulations come into play, it will be more important than ever to show benefits in costs as well as care to get healthcare providers on board.

To learn more:
- here's the Journal of General Internal Medicine abstract

Related Articles:
HIEs aim to curb ED overuse
ER departments save nearly $2M through HIE data use
Shared EHRs improve coordination of after-hours care
HIEs remain in nascent stage despite rapid growth

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