Sharing electronic health information results in financial savings
MedWire News: Emergency departments in Memphis, Tennessee, made an annual saving of nearly US$ 2 million by sharing electronic health information, according to a study published by the Journal of the American Medical Informatics Association.
"This is the first study to show that, on a city-wide basis, investments in technology can save medical costs by improving care," said Mark Frisse (Vanderbilt University, Nashville, Tennessee, USA), in a press release.
Health information exchange (HIE) allows clinicians to access medical information from other healthcare sites. This is especially important for helping coordinate care for patients who are tended to by multiple healthcare providers, explain Frisse and colleagues.
The team investigated all emergency department (ED) encounters that used HIE data in all 12 major emergency departments within the Memphis area over the course of 13 months. This set of encounter records was then matched and compared with a similar set in which HIE data were not accessed. This study population was drawn from a Tennessee Hospital Association billing database consisting of all ED visit records over the 2-year study period starting in January 2007.
Clinicians started using the HIE data in May 2006 and, as of October 2010, over 7.5 million encounter records were available regarding 1.7 million patients. HIE patient participation was on an 'opt out' basis, where 1 to 3% decided to do so. The clinicians were found to voluntarily access HIE data in approximately 6.8% of all visits to ED departments.
The study included 15,798 cases where HIE data were accessed, and an equal number of cases that involved no HIE data.
For each case, the researchers analyzed the following set of outcome variables: hospital admissions from the ED, head computer tomography (CT) scans, body CT scans, chest and ankle radiographs, echocardiogram, outpatient surgery, the number of patients receiving laboratory tests, and admissions for observation. They also conducted a financial impact assessment.
One ED was not able to access the HIE directly through the specially designed web portal and so the data for this site was analyzed separately.
The study results for the direct access group showed 191 fewer admissions when HIE was used than was expected without HIE, which was statistically significant.
They reported an overall net societal saving of US$ 1.07 million, with reduced admissions accounting for 97.6% of this.
Frisse expects the implications of this research to be wide, which he expressed in a press statement: "Emergency department care is such a very small part of our health care system, but the same value of complete information realized in emergency department settings is even more applicable when an elderly patient goes to multiple doctors without a single, comprehensive medical record."
The researchers conclude: "Our study demonstrates a positive financial impact on communities, but we believe these savings will be only a fraction of the economic benefit that will be realized as our connected digital healthcare delivery system evolves."
By Chloe McIvor