The financial impact of health information exchange on emergency department care

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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 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.[3]

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. [3]

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. [3]

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 benefits of HIE.


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
  2. 3.0 3.1 3.2