The financial impact of health information exchange on emergency department care

Abstract

ObjectiveTo examine the financial impact health information exchange (HIE) in emergency departments (EDs).Materials and MethodsWe studied all ED encounters over a 13-month period in which HIE data were accessed in all major emergency departments Memphis, Tennessee. HIE access encounter records were matched with similar encounter records without HIE access. Outcomes studied were ED-originated hospital admissions, admissions for observation, laboratory testing, head CT, body CT, ankle radiographs, chest radiographs, and echocardiograms. Our estimates employed generalized estimating equations for logistic regression models adjusted for admission type, length of stay, and Charlson co-morbidity index. Marginal probabilities were used to calculate changes in outcome variables and their financial consequences.ResultsHIE data were accessed in approximately 6.8% of ED visits across 12 EDs studied. In 11 EDs directly accessing HIE data only through a secure Web browser, access was associated with a decrease in hospital admissions (adjusted odds ratio (OR)=0.27; p<0001). In a 12th ED relying more on print summaries, HIE access was associated with a decrease in hospital admissions (OR=0.48; p<0001) and statistically significant decreases in head CT use, body CT use, and laboratory test ordering.DiscussionApplied only to the study population, HIE access was associated with an annual cost savings of $1.9 million. Net of annual operating costs, HIE access reduced overall costs by $1.07 million. Hospital admission reductions accounted for 97.6% of total cost reductions.ConclusionAccess to additional clinical data through HIE in emergency department settings is associated with net societal saving.

Health Information Exchange, System Size and Information Silos

“…Hospitals may also have a financial incentive to reduce the frequency and treatment intensity of emergency room visits, which often involve uncompensated care, and where, in addition to Medicare and Medicaid, many 7 private insurers pay a fixed fee. 5 In a case study of Memphis emergency departments, health information exchange was associated with significant decreases in utilization and costs (Frisse et al, 2012). To the extent that some of the costs of duplicative care are borne by insurers, the social value of data sharing will be larger than the private value.…”

Evaluating the Usability of a Nationwide Pharmacy Information System in Iran: Application of Nielson’s Heuristics

“…PISs are used not only to optimize the safety and efficiency of the medication use process (4), but also to connect the pharmacy department of the hospital to other hospital departments (5). Therefore, these systems can improve cost control, patient care quality, information security, information administration, and finally can lead to a decrease in medication errors (6)(7)(8).…”

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

“…1 Addressing these information gaps is critical because the timely sharing of a patient's clinical information can improve the accuracy of diagnoses, reduce the number of duplicative tests, prevent readmissions, and prevent medication errors. [2][3][4] One way to facilitate the sharing of various types of clinical information among providers and hospitals is electronic health information exchange. Historically, regional health information organizations (HIOs)-entities that can connect a myriad of stakeholders, including laboratories, public health departments, hospitals, and providers-have served as key facilitators of local exchanges of information.…”