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Research: HIEs Help Reduce Tests in Emergency Departments

July 22, 2015
by Rajiv Leventhal
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New research from the Brookings Institution on health information exchange (HIE) technology has shown a significant reduction in the duplication of tests in emergency departments (EDs).

Researchers at the Brookings Institution in cooperation with HEALTHeLINK, the Western New York HIE, conducted a pilot study to examine the impact of the use of HIE technology on reducing laboratory tests and radiology examinations in EDs at three area hospitals. The results of the pilot, which were recently published in the Journal of the American Medical Informatics Association and the Center for Technology Innovation at Brookings, show a significant reduction in the duplication of tests.

HEALTHeLINK’s clinical liaisons shadowed physicians within the EDs at Kenmore Mercy Hospital, Erie County Medical Center and Buffalo General Medical Center for a six to eight week period last year. A total of 1,450 patients were seen in these three EDs during this period. According to study results, querying HEALTHeLINK’s HIE in the ED setting resulted in a reduction in ordering of laboratory tests and radiology exams.

  • In the first ED setting, accessing patients’ information within HEALTHeLINK, led to a 52 percent reduction in the estimated number of laboratory tests and a 36 percent reduction in the estimated number of radiology exams.
  • In the second ED setting, having clinically relevant patient information resulted in a 25 percent and 26 percent reduction in the estimated number of laboratory tests and radiology exams.
  •  Finally, the third ED setting was associated with a 47 percent reduction in the estimated number of radiology exams. Querying the HIE in this setting did not affect the total number of laboratory orders as patients were being seen for cardiac and neurovascular issues which require new laboratory tests regardless of past results.

“This study highlights just one component of the value of interoperability and doctors’ access to their patients’ data that HEALTHeLINK and health information technology can provide in improving the quality and efficiency of patient care and enhancing patient safety,” Dan Porreca, executive director, HEALTHeLINK, said in a statement. “While this study focused on only three emergency department settings, we are hearing from other physicians and medical staff from hospitals and healthcare organizations throughout Western New York about the benefits of utilizing HEALTHeLINK.”

The goal of the study was to better understand the clinical relevance of HIE and value of patient information in this setting and subsequently increase utilization of HEALTHeLINK based on results. The clinical liaison retrieved any potential clinically relevant information 100 percent of the time for consented patients. The medical information accessed included previous laboratory results, radiology examinations, hospital admissions and discharge transcripts, operative reports and medication history.

“While direct and indirect costs of these tests can vary by hospital and region, physicians ordering fewer tests because recent pertinent clinical information is available through HEALTHeLINK directly leads to overall costs savings for our local healthcare community,” added Porreca. “As part of the Statewide Health Information Network of New York (SHIN-NY), the value we provide gets multiplied statewide by other HIE organizations providing similar services within their respective regions.  Add to that the ability, via the SHIN-NY, to connect providers across the state and the value grows even further.”

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