The financial impact of health information exchange on emergency department care
This is a review of the Frisse et al article "The financial impact of health information exchange on emergency department care".
Delivery of care usually occurs at multiple settings and sites. To help improve this coordination of care and the continuity of it, HIEs were formed. Health Information Exchanges (HIE) are supposed to be enhance the continuity of patient care. It allows clinicians to gain access to patient data coming from other locations of care. HIE is slowly growing on a national level, but since it is still a growing technology, most of its benefits have not truly been truly recorded and measured. The purpose of the article is to discover the impact health information exchanges have on hospital admission and diagnostic testing in the emergency department setting. 
The methodology used for this study included studying all ED encounters over a 13 month period. Coming from all major EDs in Memphis, TN, all HIE data was accessed and pulled for. These HIE records were matched with similar encounter records without HIE access. The study focused on ED-originated hospital admissions, lab testing such as head CTs, body CTs, radiographs, and other actions related to ED encounters. The regression models used were to measure the admission type, length of stay and co-morbidity index.
From their findings, HIE data was accessed about 6.8% of ED visits out of all 12 EDs in the city. 11 of these EDs used a secure web browser to access the HIE. These were associated with a decrease in hospital admissions. The 1 other ED used print summaries, the HIE data access was also associated with a decrease in hospital admissions. More notably, there was a significant decrease in head CT, body CT and lab orders. HIE access resulted in a $1.9 million cost in annual savings. It also reduced overall costs by $1.07 million. The reduction in hospital admissions accounted for 97.6% of these savings.
Based on the results, having the ability to access HIE data, thus more clinical data, was associated with a net saving in an emergency department setting.
Studies like this need to be done more frequently to prove the value and benefits of HIE. It is very interesting how much cost savings there was in this study. While the HIE may not have significant impact in other specialties and departments, the study clearly shows the benefits it does have in an emergency department setting. The reduction in redundant testing and hospital admissions benefits both the patient and cost of healthcare.
In addition to the cost of tests as mentioned in the study, there are potential benefits of saving the patients from extra radiation they receive due to extra CT scans. This in itself is a huge benefit to the patients. Patients with functional disorder tend to hop from ER to ER and receive numerous tests done including CT scans. With a reliable and real time access to the radiological studies done elsewhere, as it was noted in this study, there was less use of radiological test.
- Frisse, M., Johnson, K., Hui,N., Davison, C., Gadd, C., & Unertl, K. (2011). The financial impact of health information exchange on emergency department care. Cost-effectiveness of informatics and health IT: impact on finances and quality of care. J Am Med Inform Assoc. 19(3), 328-333. Retrieved October 19, 2015 from http://jamia.oxfordjournals.org/content/19/3/328