The use of health information exchange (HIE) to share reports on imaging tests, such as X-rays and MRIs, can help reduce the number of times patients undergo the exact same test, according to Weill Cornell Medical College researchers. Their study, published Jan. 14 in the American Journal of Managed Care, suggests HIE technology that gives healthcare providers immediate, electronic access to a patient's medical history may improve the quality of care while reducing unnecessary costs.
"Medical imaging has been an important diagnostic tool for decades, but unnecessary or repeat exams are costly and could potentially delay access for patients who truly need the tests," says Dr. Joshua Vest, assistant professor of healthcare policy and research at Weill Cornell and the lead author of the study. "Our research shows that timely sharing of patients' medical records may result in fewer repeated imaging tests. Instant access to this information gives providers a better, more complete picture of a patient's health status."
Dr. Joshua Vest. Photo credit: Carlos Rene Perez
Driven by recent increases in federal and state funding, healthcare systems are increasingly adopting web-based HIE systems that consolidate patients' diverse health information, such as lab tests, radiology reports, and hospital discharge summaries. The study evaluated the Rochester Regional Health Information Organization (RHIO), an HIE that — with patients' permission — collects their health records from multiple providers and insurers in western New York and makes that information available during office and emergency care visits.
Researchers looked at data from insured patients who consented to sharing their imaging results, and assessed how often providers retrieved the patients' electronic health records. After examining the number of repeat imaging tests performed within 90 days of the initial test, the researchers found that providers using HIE were 25 percent less likely than their peers to perform the same test again. The study was funded by the New York State Department of Health's Healthcare Efficiency and Affordability Law for New Yorkers (HEAL NY).
Rochester RHIO has been very successful in implementing HIE and has a robust research agenda resulting in several important studies, according to Dr. Vest. For example, earlier this year, he and senior author Dr. Rainu Kaushal led a study in Rochester demonstrating that HIE reduced hospital admissions.
"Rochester RHIO is leading a very valuable community initiative leveraging patient-centered health information technology for improved care delivery," says Dr. Kaushal, chair of the Department of Healthcare Policy and Research, the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell, and public health physician-in-chief at NewYork-Presbyterian Hospital. "As HIE for clinical purposes continues to expand, patients across the country will benefit as providers have more information readily available at the point of care."