Does Health Information Exchange Reduce Redundant Imaging
This is a review of Lammers’ article "Does Health Information Exchange Reduce Redundant Imaging? Evidence From Emergency Departments".
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. 
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.
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. 
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. 
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 benefits of HIE.
- 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