Lack of access to patient health records at the point of care often leads to repetition of medical procedures. However, health information exchange significantly lowers repetitions of therapeutic medical procedures, while diagnostic procedures are not impacted.
That’s the finding of a recent study examining the impact of HIE on diagnostic medical procedures as well as therapeutic medical procedures performed in office settings.
Saeede Eftekhari, co-author of the study and a Ph.D. candidate in the business school at the State University of New York at Buffalo, notes that the repetition of medical services by providers is one of the major sources of healthcare costs in this country.
“In the United States, repetitive medical services account for almost 30 percent of healthcare annual costs,” says Eftekhari. “These repetitions are both risky and costly.”
Leveraging publicly available data from the Centers for Medicare and Medicaid Services and HEALTHeLINK, a regional HIE serving Western New York, the longitudinal study focused on the adoption and usage behaviors of more than 2,000 physicians within 430 community medical practices. The study assessed 110 types of diagnostic procedures and 97 types of therapeutic medical procedures.
“Our key findings suggest that HIE helps to reduce repetitions of therapeutic medical procedures, but does not seem to impact diagnostic procedures,” researchers noted. “Further, we found evidence that impact of HIE on repetitions is more efficient for those who do not participate in (Physician Quality Reporting System) program. However, our results did not reveal that the level of complexity of medical procedures makes HIE impact stronger.”
According to the authors, by conducting separate analysis of diagnostic and therapeutic medical procedures, they have “shown that the HIE does not impact different types of medical procedures in the same way.” In addition, they contend that their study is “among the first studies that provide evidence for the effectiveness of HIE usage in office settings.”
“The results of this recent Brookings (Institution), University of Buffalo and University of Connecticut study are gratifying and again illustrate that community HIEs such as HEALTHeLINK are on the right track when it comes to supporting our communities’ efforts for improving the quality of patient care, enhancing patient safety and reducing healthcare costs,” says HEALTHeLINK Executive Director Daniel Porreca.
But, Julia Adler-Milstein, associate professor in the School of Information at the University of Michigan, is more reserved on the projected benefits identified by the research. While the paper is “novel and interesting, using robust methods,” she is not quite sure how to make sense of the paper’s key finding.
“Most of the prior evidence has found reductions in diagnostic utilization, which this study does not find,” Adler-Milstein points out. “Yet, they do find a reduction in therapeutic utilization but do not explain plausible scenarios in which HIE would drive this. Because the paper doesn’t list the specific procedures determined to be therapeutic, it’s hard to explain what might be going on.”
Nonetheless, Porreca contends that, based on HEALTHeLINK’s “understanding of the methodology used and the data researchers had available,” his HIE believes these are conservative numbers and the potential cost savings and reduction in repetitive tests are very likely significantly more.
“Regardless, results like these renew our resolve to ensure doctors and other healthcare providers can efficiently utilize the information that is available through HEALTHeLINK at the point of care to more effectively treat their patients,” he concludes.
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