Estimated financial savings associated with health information exchange and ambulatory care referral

Abstract

Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of reducing these costs depends on the extent to which clinicians alter their workflow and take into account information available through the exchange from other institutions prior to initiating a treatment plan. Far greater savings can be realized in theory by identifying individuals presenting to emergency departments whose acute and long-term care needs are more suitably addressed at lower costs in ambulatory settings or medical homes. These alternative ambulatory settings can more effectively address the chronic care needs of those who receive most of their care in emergency departments. To support a shift from emergency room care to clinic care, health care information available through the health information exchange must be made available in both emergency department and ambulatory care settings. If practice workflow and patient behavior can be changed, a more effective and efficient care delivery system will be made possible through the secure exchange of clinical information across regional settings. These projections support the case for the financial viability of regional health information exchanges and motivate participation of hospitals and ambulatory care organizations-particularly in urban settings.

Systematic Review of Health Information Exchange in Primary Care Practices

“…9,10,16,37,43 By contrast, an incremental building philosophy that capitalized on existing infrastructure and data-sharing efforts showed early promise in Tennessee. 2 Examples of achievable early successes include access to test results and clinical notes. 14,15 Public health reporting that provides primary care practices with outbreak/epidemic surveillance information, reporting services, or provider/patient notification assistance also provides value.…”

“…Practices may be unable to downsize because staff often perform multiple office tasks. 2,3,31 HIE may result in savings for the overall health care system by reducing redundant tests and through better medical decision making that shortens hospital stays. One cost-benefit model suggests that at the highest level of interoperability, nationwide HIE would have a net value of $77.8 billion per year after the first 10 years.…”

Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

“…H ealth information exchange (HIE), defined as the electronic transmission of healthcare information among organizations, 1 is expected to improve quality of care, reduce medical error, and lower healthcare costs, [2][3][4][5][6][7][8][9] and HIE systems have become more prevalent worldwide as many countries have recognized the potential of the technology. 3,6,10,11 The need for efficient and effective ways to exchange clinical information among providers is particularly great in South Korea, where physician care at clinics is discontinued when a patient moves to a hospital or other clinic for further management.…”

Giving Office-Based Physicians Electronic Access To Patients’ Prior Imaging And Lab Results Did Not Deter Ordering Of Tests

“…[1][2][3][4][5][6] In fact, support for passage of the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act of 2009, which dramatically expanded federal expenditures for the adoption of health information technology, rested heavily on this argument. 7 Reduced ordering of imaging and other diagnostic studies is often cited as a likely mechanism for cost savings related to health information technology.…”