Difference between revisions of "Does Health Information Exchange Reduce Redundant Imaging"

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This is a review of Lammers’ article "Does Health Information Exchange Reduce Redundant Imaging? Evidence From Emergency Departments".<ref name="Lammers 2014">Lammers, E., Adler-Milstein, J., & Kocher, K. (2014). Does Health Information Exchange Reduce Redundant Imaging? Evidence From Emergency Departments. Medical Care, 52(3), 227-234. Retrieved October 5, 2015 from http://journals.lww.com/lww-medicalcare/pages/default.aspx</ref>  
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This is a review of the article "A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use".<ref name="Adler-Milstein 2011">Adler-Milstein, J., Bates, D & Jha, A. (2011). A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use. Annals of Internal Medicine, 154(10), 666-671. </ref>
  
 
== Background ==
 
== Background ==
[[HIE|Health Information Exchanges (HIE)]] are supposed to be enhance the continuity of patient care. It allows the sharing of patient data between different points of care. In an ideal world, HIEs should provide great benefit including quality gains and cost savings. Despite this notion, there has been limited supporting evidence and research done to prove that HIEs produce these results. The purpose of the article is to evaluate the use of HIE and whether it is associated with a decline in repeat imaging in emergency departments. <ref name="Lammers 2014"> </ref>
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[[HIE|Health Information Exchanges (HIE)]] are an integral part of receiving financial reimbursement for physicians and hospitals. Their EHRs must be connected to a health information exchange. The most common approach available to providers is to connect to a regional organization that supports an HIE. The purpose of the article is to assess the use of HIEs across the country through regional health information organizations (RHIOs).<ref name="Adler-Milstein 2011"></ref>
  
 
== Methods ==
 
== Methods ==
The methodology used for this research was used to compare the effects and trends of 37 EDs utilized by 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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179 RHIOs located in the U.S. that utilized an HIE were surveyed. Items that were asked for were operational RHIOs that supported meaningful use stage 1 that included the support for a working HIE. It also surveyed the number of hospitals and practices involved with the RHIOs.<ref name="Adler-Milstein 2011"> </ref>
  
 
== Results ==
 
== Results ==
From the samples, they discovered that there were repeats of the following 14.7% of CTs, 20.7 of Ultrasounds, 19.5% of chest x-rays. HIE was then associated to reduced probability of repeats in all 3 tests with about 95% confidence level. <ref name="Lammers 2014"> </ref>
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91% (179) of the total 197 RHIOs in the country reported their status and 84% completed their surveys. Only 75 RHIOs were operational that covered 14% of hospitals and 3% of outpatient practices. 3% of hospitals and 0.9% of practices were a part of the 13 RHIOs that supported stage 1 of meaningful use. Also, 50 of 75 RHIOs did not meet financial viability. <ref name="Adler-Milstein 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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From the survey results, the RHIOs are called into question whether they can be effective in connecting hospitals and practices with robust HIEs. <ref name="Adler-Milstein 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 of HIE. By decreasing redundant tests (among other things), HIE can reduce the costs of healthcare. However, many organizations have been slow to adopt 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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Although the data from the survey was self reported, and the sample may not include all efforts in the HIE space, it is clear that the RHIOs have not clearly shown to be effective in supporting practice/hospital engagement with HIEs. There are many [[EMR_Benefits:_HIE|benefits]] of HIE but surveys such as these shows that many of those benefits may originate from ideal situations. There are many challenges for integrating health information and I believe more research needs to be done to prove the value in HIE.
  
  

Latest revision as of 03:31, 14 October 2015

This is a review of the article "A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use".[1]

Background

Health Information Exchanges (HIE) are an integral part of receiving financial reimbursement for physicians and hospitals. Their EHRs must be connected to a health information exchange. The most common approach available to providers is to connect to a regional organization that supports an HIE. The purpose of the article is to assess the use of HIEs across the country through regional health information organizations (RHIOs).[1]

Methods

179 RHIOs located in the U.S. that utilized an HIE were surveyed. Items that were asked for were operational RHIOs that supported meaningful use stage 1 that included the support for a working HIE. It also surveyed the number of hospitals and practices involved with the RHIOs.[1]

Results

91% (179) of the total 197 RHIOs in the country reported their status and 84% completed their surveys. Only 75 RHIOs were operational that covered 14% of hospitals and 3% of outpatient practices. 3% of hospitals and 0.9% of practices were a part of the 13 RHIOs that supported stage 1 of meaningful use. Also, 50 of 75 RHIOs did not meet financial viability. [1]

Conclusion

From the survey results, the RHIOs are called into question whether they can be effective in connecting hospitals and practices with robust HIEs. [1]

Comments

Although the data from the survey was self reported, and the sample may not include all efforts in the HIE space, it is clear that the RHIOs have not clearly shown to be effective in supporting practice/hospital engagement with HIEs. There are many benefits of HIE but surveys such as these shows that many of those benefits may originate from ideal situations. There are many challenges for integrating health information and I believe more research needs to be done to prove the value in HIE.


References

  1. 1.0 1.1 1.2 1.3 1.4 Adler-Milstein, J., Bates, D & Jha, A. (2011). A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use. Annals of Internal Medicine, 154(10), 666-671.