Difference between revisions of "The financial impact of health information exchange on emergency department care"

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== Methods ==
 
== Methods ==
The methodology used for this research was to compare the effects and trends of 37 EDs utilized an HIE during a time period to 410 EDs that did not participate in an HIE. The 3 imaging orders accounted for were CT Scans(computed tomography), ultrasounds, and chest x-rays. The data used came from the State Emergency Department Databases for California and Florida in 2007-2010 along with HIMSS data of hospitals participating in HIE. The article defined repeat image test as the same test done in the same body region within 30 days at unaffiliated EDs.<ref name="Lammers 2014"> </ref>
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The methodology used for this study included studying all ED encounters over a 13 month period. Coming from all major EDs in Memphis, TN, all HIE data was accessed and pulled for. These HIE records were matched with similar encounter records without HIE access. The study focused on ED-originated hospital admissions, lab testing such as head CTs, body CTs, radiographs etc. The regression models used were to measure the admission type, length of stay and co-morbidity index. <ref name="Frisse 2011”> </ref>
  
 
== Results ==
 
== Results ==
From the samples, they discovered that there were repeats of 14.7% of CTs, 20.7 of Ultrasounds, 19.5% of chest x-rays. HIE was then associated to reduced probability of repeat in all 3 tests with about 95% confidence level. <ref name="Lammers 2014"> </ref>
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From their findings, HIE data was accessed about 6.8% of ED visits out of all 12 EDs in the city. 11 of these EDs used a secure web browser to access the HIE. These were associated with a decrease in hospital admissions. The 1 other ED used print summaries, the HIE data access was also associated with a decrease in hospital admissions. More notably, there was a significant decrease in head CT, body CT and lab orders. HIE access resulted in a $1.9 million cost in annual savings. It also reduced overall costs by $1.07 million. The reduction in hospital admissions accounted for 97.6% of these savings. <ref name="Frisse 2011”> </ref>
  
 
== Conclusion ==
 
== Conclusion ==
Based on the results, they have found a relationship between HIE and repeat imaging in an ED environment. Thus HIE can be a potential tool in decreasing redundant medical services, creating savings in cost and care. <ref name="Lammers 2014"> </ref>
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Based on the results, having the ability to access HIE data, thus more clinical data was associated with a net saving in an emergency department setting. <ref name="Frisse 2011”> </ref>
  
 
== Comments ==  
 
== Comments ==  
This is an interesting article as it is the first of its kind to assess and provide evidence of the benefits an HIE can have. HIE is a technology that can help reduce the costs in healthcare such as decrease in redundant tests. However, it has been slow to adopt by many organizations due to strict data sharing policies and lack of trust between providers. I believe more studies like this need to be done to prove the value and [[EMR_Benefits:_HIE|benefits]] of HIE.  
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Studies like this need to be done more frequently to prove the value and [[EMR_Benefits:_HIE|benefits]] of HIE. It is very interesting how much cost savings there was in this study. While the HIE may not have significant impact in other specialties and departments, the study clearly shows the benefits it does have in an emergency department setting. The reduction in redundant testing and hospital admissions benefits both the patient and cost of healthcare.  
  
  

Revision as of 01:05, 21 October 2015

This is a review of Frisse’s article "The financial impact of health information exchange on emergency department care".[1]

Background

Delivery of care usually occurs at multiple settings and sites. To help improve this coordination of care and the continuity of it, HIEs were formed. Health Information Exchanges (HIE) are supposed to be enhance the continuity of patient care. It allows clinicians to gain access to patient data coming from other locations of care. HIE is slowly growing on a national level, but since it is still a growing technology, most of its benefits have not truly been truly recorded and measured. The purpose of the article is to discover the impact health information exchanges have on hospital admission and diagnostic testing in the emergency department setting. [2]

Methods

The methodology used for this study included studying all ED encounters over a 13 month period. Coming from all major EDs in Memphis, TN, all HIE data was accessed and pulled for. These HIE records were matched with similar encounter records without HIE access. The study focused on ED-originated hospital admissions, lab testing such as head CTs, body CTs, radiographs etc. The regression models used were to measure the admission type, length of stay and co-morbidity index. [3]

Results

From their findings, HIE data was accessed about 6.8% of ED visits out of all 12 EDs in the city. 11 of these EDs used a secure web browser to access the HIE. These were associated with a decrease in hospital admissions. The 1 other ED used print summaries, the HIE data access was also associated with a decrease in hospital admissions. More notably, there was a significant decrease in head CT, body CT and lab orders. HIE access resulted in a $1.9 million cost in annual savings. It also reduced overall costs by $1.07 million. The reduction in hospital admissions accounted for 97.6% of these savings. [4]

Conclusion

Based on the results, having the ability to access HIE data, thus more clinical data was associated with a net saving in an emergency department setting. [5]

Comments

Studies like this need to be done more frequently to prove the value and benefits of HIE. It is very interesting how much cost savings there was in this study. While the HIE may not have significant impact in other specialties and departments, the study clearly shows the benefits it does have in an emergency department setting. The reduction in redundant testing and hospital admissions benefits both the patient and cost of healthcare.


References

  1. Frisse, M., Johnson, K., Hui,N., Davison, C., Gadd, C., & Unertl, K. (2011). The financial impact of health information exchange on emergency department care. Cost-effectiveness of informatics and health IT: impact on finances and quality of care. J Am Med Inform Assoc. 19(3), 328-333. Retrieved October 19, 2015 from http://jamia.oxfordjournals.org/content/19/3/328