HIEs significantly reduce chances of repeat imaging

Health information exchanges (HIEs) can reduce the chances of unnecessary repeat imaging procedures by as much as 25 percent, according to a study published online Jan. 14 in the American Journal of Managed Care.

The authors, including Joshua R. Vest, PhD, MPH, with Weill Cornell Medical Center in New York City, estimated that between 9 and 40 percent of all medical images are repeat examinations. Some are medically necessary to determine changes in a patient’s condition, but many unnecessary repeat images occur because providers lack quick access to a patient’s previous imaging data.

In the case of repeated imaging, HIEs can potentially reduce the frequency of unnecessary exams by enabling providers to electronically access patient clinical information—even information collected by other providers.

The researchers in this study set out to measure the frequency and timing of repeat images in a community-based setting as well as to determine the effect that an HIE would have on reducing the number of repeat images.

“Our study may be highly generalizable because it took place in a multi-payer, multi-provider community that used a commercially available HIE system,” Vest and colleagues wrote.

For the study, the authors examined data from a community-based HIE program that included 11 counties in New York. The cohort included 196,314 patients.

Of these patients, 34,604 (18 percent) had at least one imaging procedure between 2009 and 2010.  This figure was equivalent to a rate of 28.7 images per 100 patients.

Overall, the researchers found that 7.7 percent of the images were repeated within a 90-day time period. In cases where the HIE system was accessed, repeat imaging was significantly less likely to occur—5 percent repeated with HIE access compared with 8 percent repeated without HIE access.

“Adjusting for potential confounders, the odds that an imaging procedure was repeated decreased by 25 percent with HIE access,” the authors wrote.

Vest and colleagues described their study as one of the few estimates of the frequency of repeat imaging for multiple modalities. Additionally, they wrote that while other interventions like clinical decision support systems for ordering physicians have been touted as a way to decrease unnecessary imaging, they are still emerging tools that may not be widely available in all communities.

“This study demonstrates that a community-wide portal is effective for reducing the frequency of repeat imaging,” the authors concluded, adding that such improvements can lead to higher quality and potentially lower costs.”