Quicker access to info provides care quality benefits

A new study shows health information exchange can improve emergency department care through faster access to patient information held by outside healthcare organizations.

The study focused on Epic Systems’ Care Everywhere HIE platform to assess whether it provided more timely information access in the ED, compared with standard telephone- and fax-based approaches to information retrieval from outside organizations. In the study, outside information requests were either fulfilled via Epic’s Care Everywhere or fax/scan to the electronic health record system.

The results, published in the Journal of the American Medical Informatics Association, included EHR audit log data from 2,163 patients seen in the ED at the University of Michigan Health System from February 2014 to February 2015.

“Those were all the patients for whom an outside record request was made during a one-year time period,” says Julia Adler-Milstein, co-author of the article and assistant professor in the School of Information and School of Public Health at the University of Michigan.


According to Adler-Milstein, patient information from outside healthcare organizations was readily available to ED staff using Epic’s Care Everywhere. She notes that the HIE platform was associated with faster outside information access (58.5 minutes on average) versus fax/scan, and faster access was associated with more efficient ED care.

“When the information came back via fax, clinicians saw the information almost an hour later than HIE,” observes Adler-Milstein. “The sooner the information comes in, the sooner the clinician actually sees it. When it comes back slower, the impact on care is less.”

Though there was no direct association between return of information via HIE versus fax/scan and ED outcomes, the study results reveal that for each 1-hour reduction in access time, visit length was 52.9 minutes shorter; the likelihood of imaging was lower (by 2.5, 1.6, and 2.4 percentage points for CT, MRI, and radiographs, respectively); the likelihood of admission was 2.4 percentage points lower; and average charges were $1,187 lower.

“While our study focuses on one type of HIE, Care Everywhere, it is likely that the benefits from faster access to information could be realized using different approaches to HIE,” concludes the JAMIA article. “Provider organizations are therefore likely to benefit from investing in forms of HIE and associated workflows that ensure that ED clinicians can view information from outside organizations in a timely manner.”

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