Provider who can access patient records through an electronic health information exchange (HIE) order fewer repeat X-rays, ultrasounds and other imaging tests, resulting in cost savings, according to a study published in the Journal of the American College of Radiology.
According to research investigators from Weill Cornell Medicine, who conducted the study, imaging procedures constitute a large portion of healthcare expenditures, with the federal Medicare program along spending $10 billion annually on medical imaging, and repeat imaging is a substantial contributor to imaging costs.
For the study, researchers examined the relationship between provider use of HIE and cost savings associated with repeat imaging. The researchers used data from 12,620 patients who underwent imaging procedures during 2009 and 2010 in western New York State. The patients consented to have their information made accessible to providers participating in the Rochester Regional Health Information Organization (RHIO), a non-profit that facilitates HIE in a 13-county region.
To calculate the estimated savings, investigators looked at patients who had an imaging test done, and within 90 days, went back to a healthcare provider, where a possible repeat imaging procedure could have been run. If fewer repeat imaging tests were conducted when a provider accessed information in the exchange, they were counted towards savings.
The majority of the patients in the sample underwent basic imaging procedures, with radiography (45 percent), mammography (9 percent) and ultrasound (15 percent) accounting for approximately 70 percent of all procedures. Among advanced imaging procedures, CT was the most common (14 percent), followed by MRI (8 percent). On average, repeated imaging procedures were conducted 40 days after the index imaging procedure.
Among those imaging studies for which the HIE system was accessed, 5.5 percent of those imaging studies were repeated within 90 days, which was a lower percentage of repeat imaging than with the group with no HIE system use, 6.7 percent. Overall, use of the HIE system after an index imaging procedure was associated with a 19 percent reduction in the odds of a procedure’s being repeated within 90 days, the study authors wrote.
The researchers estimated the use of the HIE system avoided 47 cases of repeated imaging procedures, generating $8,115 in cost savings, or an estimated annual savings of $32,460 in avoided repeat imaging, which is an annual per patient savings of $2.57.
Basic imaging (radiography, ultrasound, and mammography) accounted for 85 percent of the estimated avoided cases of repeat imaging and 46 percent of estimated cost savings. Advanced imaging (CT and MRI) accounted for 13 percent of avoided procedures but constituted half of the estimated savings (50 percent).
The researchers concluded, “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."