HIE driving down utilization, costs
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Widespread hospital support for HIE and initial deployment only in emergency department (ED) settings can lower overall societal costs and reduce hospital admissions, according to a study published in the May edition of the Journal of the American Medical Informatics Association.
Researchers from Vanderbilt University in Nashville, Tenn., sought to examine the financial impact of HIE in EDs. They studied all ED encounters over a 13-month period in which HIE data were accessed in all major EDs in Memphis, Tenn. As of Oct. 1, 2010, clinicians had access to over 7.5 million encounter records on 1.7 million patients, 4.9 million chief complaints, 45 million laboratory tests, five million radiology reports, as well as 2.1 million other reports and documents. HIE access encounter records were matched with similar encounter records without HIE access. Outcomes studied were ED-originated hospital admissions, admissions for observation, laboratory testing, head CT, body CT, ankle radiographs, chest radiographs and echocardiograms.
“Applied only to the study population, HIE access was associated with an annual cost savings of $1.9 million,” the authors wrote. “Net of annual operating costs, HIE access reduced overall costs by $1.07 million. Hospital admission reductions accounted for 97.6 percent of total cost reductions.”
Another study showed that having access to patients' lab results influences the decision-making process regarding the ordering of further tests, which supports the predictions of financial savings made in the HIE cost-benefit models.
Published in the Archives of Internal Medicine, researchers from Harvard Medical School and Partners HealthCare in Boston, conducted a retrospective study to investigate whether the availability of laboratory results from a nonencounter hospital reduced the number of subsequent laboratory tests at the encounter hospital.
A single new consultation encounter—the index encounter—served as a unit of analysis. The number of laboratory tests performed until the end of the day of the index encounter at the same institution as the encounter (post-encounter, on-site tests) served as the primary outcome variable.
The study found that the introduction of an internal HIE was associated with a reduction in laboratory tests as high as 50 percent.
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Beth Walsh
CMIO Editor
[email protected]
Beth Walsh, Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.