Use of Health Information Exchange and Repeat Imaging Costs

Abstract

Purpose The aim of this study was to quantify the association between health information exchange (HIE) use and cost savings attributable to repeat imaging. Methods Imaging procedures associated with HIE were compared with concurrent controls on the basis of propensity score matching over the period from 2009 to 2010 in a longitudinal cohort study. The study sample (n = 12,620) included patients ages 18 years and older enrolled in the two largest commercial health plans in a 13-county region of western New York State served by the Rochester Regional Health Information Organization. The primary outcome was a continuous measure of costs associated with repeat imaging. The determinant of interest, HIE use, was defined as system access after the initial imaging procedure and before repeat imaging. Results HIE use was associated with an overall estimated annual savings of $32,460 in avoided repeat imaging, or $2.57 per patient. Basic imaging (radiography, ultrasound, and mammography) accounted for 85% of the estimated avoided cases of repeat imaging. Advanced imaging (CT and MRI) accounted for 13% of avoided procedures but constituted half of the estimated savings (50%). Conclusions HIE systems may reduce costs associated with repeat imaging. Although inexpensive imaging procedures constituted the largest proportion of avoided repeat imaging in our study, most of the estimated cost savings were due to small reductions in repeated advanced imaging procedures. HIE systems will need to be leveraged in ways that facilitate greater reductions in advanced imaging to achieve appreciable cost savings.

The implications and impact of 3 approaches to health information exchange: community, enterprise, and vendor‐mediated health information exchange

“…Early estimates of the savings generated by MSeHA pointed towards large financial benefits and a later study indicated lower, but substantial, benefits from it . Several studies have demonstrated that community HIEs can reduce the rate of imaging . Community HIE participation in Wisconsin that linked 5 competitive systems was shown to save $29 per visit .…”

“…51 Several studies have demonstrated that community HIEs can reduce the rate of imaging. 42,43,52 Community HIE participation in Wisconsin that linked 5 competitive systems was shown to save $29 per visit. 53 A Colorado-based community HIE demonstrated that community HIE adoption was associated with reduced lab testing, but the benefits were smaller than anticipated, and another examination of lab testing showed no effect.…”

Enhancing Value of MRI: A Call for Action

“…Use of health information exchange (HIE) is reported to generate ∼$32,460 in estimated annual savings through avoided repeat imaging among 12,620 propensity score matched patients. Although 85% of the avoided studies were basic imaging (X‐rays, ultrasound, and mammography) and 13% were advanced imaging, CT or MR accounted for half of the estimated savings . Interoperability of Health IT plays a critical role to reduce repeating imaging studies.…”

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].…”