The potential for community-based health information exchange systems to reduce hospital readmissions

Abstract

Background Hospital readmissions are common, costly, and offer opportunities for utilization reduction. Electronic health information exchange (HIE) systems may help prevent readmissions by improving access to clinical data by ambulatory providers after discharge from the hospital. Objective We sought to determine the association between HIE system usage and 30-day same-cause hospital readmissions among patients who consented and participated in an operational community-wide HIE during a 6-month period in 2009–2010. Methods We identified a retrospective cohort of hospital readmissions among adult patients in the Rochester, New York area. We analyzed claims files from two health plans that insure more than 60% of the area population. To be included in the dataset, patients needed to be continuously enrolled in the health plan with at least one encounter with a participating provider in the 6 months following consent to be included in the HIE system. Each patient appeared in the dataset only once and each discharge could be followed for at least 30 days. Results We found that accessing patient information in the HIE system in the 30 days after discharge was associated with a 57% lower adjusted odds of readmission (OR 0.43; 95% CI 0.27 to 0.70). The estimated annual savings in the sample from averted readmissions associated with HIE usage was $605 000. Conclusions These findings indicate that usage of an electronic HIE system in the ambulatory setting within 30 days after hospital discharge may effectively prevent hospital readmissions, thereby supporting the need for ongoing HIE efforts.

Physician EHR Adoption and Potentially Preventable Hospital Admissions among Medicare Beneficiaries: Panel Data Evidence, 2010–2013

“…; Vest et al. , ), whereas others found no link between EHRs and the two use measures (Agha ; Han et al. ; Kaushal, Edwards, and Kern ).…”

“…; Kaushal, Edwards, and Kern ; Vest et al. ), and a few recent studies have examined the relationship between health IT use in ambulatory care settings, including EHR use and disease registries, and ACSC admissions (Han et al. ; O'Malley, Reschovsky, and Saiontz‐Martinez ).…”

“…Most nationwide studies of the role of EHRs in improving quality of care, whether in terms of processes of care (McCullough et al 2010;Miller and Tucker 2011;Appari, Johnson, and Anthony 2013;McCullough, Parente, and Town 2013) or outcomes for patients (Miller and Tucker 2011;McCullough, Parente, and Town 2013;Agha 2014), have focused on EHR use by hospitals. Several studies have examined the impact of physician use of interoperable EHRs and electronic health information exchange, usually in one community or region of the United States (Frisse et al 2012;Kaushal, Edwards, and Kern 2015;Vest et al 2015), and a few recent studies have examined the relationship between health IT use in ambulatory care settings, including EHR use and disease registries, and ACSC admissions (Han et al 2014;O'Malley, Reschovsky, and Saiontz-Martinez 2015).…”

Key Factors Affecting Ambulatory Care Providers’ Electronic Exchange of Health Information With Affiliated and Unaffiliated Partners: Web-Based Survey Study (Preprint)

“…Studies on HIE outcomes have reported modest to moderate reductions in duplicate laboratory and radiology testing [4][5][6], better identification of medication discrepancies and improved medication reconciliation [7]. HIE use has also decreased hospital readmissions and associated costs [8]. Faster access to patient information via HIE has enhanced the emergency care and reduced costs [9].…”

Data Withholding in the Age of Digital Health

“…That said, HIE brings huge potential benefits for patients, clinicians, and society. HIE facilitates better and safer care for patients . It may reduce society's health care expenses—and patients’ out‐of‐pocket costs—by avoiding unnecessary diagnostic and therapeutic interventions.…”