Providers who have access to patient records through an electronic health information exchange order fewer repeat X-rays, ultrasounds and other imaging tests, investigators from Weill Cornell Medicine found in a new study. Ordering fewer tests — specifically advanced imaging procedures, like CT scans and MRIs — can result in moderate annual healthcare savings.
For their study, published in the December issue of the Journal of the American College of Radiology, the investigators used data from 12,620 patients based in western New York State between 2009 and 2010. Each of these patients underwent imaging procedures during that time period, and prior to testing, consented to have their health information made accessible through a health information exchange that shared records between hospitals, health centers, radiology groups, insurers and other necessary parties in a 13-county region. This means that the 1,318 authorized physicians and clinicians could access patient information through a query-based Web portal when the patient was in front of them, before making decisions about their care."Given the large investment in health information technology in this country — $30 billion as part of the federal government's meaningful use program alone — it's important to show that this technology is leading to actual savings," said lead investigator Dr. Hye-Young Jung, an assistant professor of healthcare policy and research at Weill Cornell Medicine. "Identifying real cost savings like these shows payers and policymakers that investing in this technology is worthwhile."
In all, the health information exchange was associated with an estimated annual savings of $32,460 in repeat imaging in this region, or $2.57 savings per patient. While cheaper procedures, like X-rays, were more likely to be skipped the second time around, real savings came from the reduction in advanced imaging procedures, said collaborator Dr. Mark Unruh, an assistant professor of healthcare policy and research at Weill Cornell Medicine.To calculate the estimated savings, investigators looked at patients who had an imaging test done, and within 90 days, went back to a healthcare provider, where a possible repeat imaging procedure could have been run. If fewer repeat imaging tests were conducted when a provider accessed information in the exchange, they were counted towards savings.
"Although these estimated savings are moderate, we covered broad populations and used data from the exchange that indicated whether a provider actually accessed a patient's health information," Dr. Unruh said. "Looking ahead, we'd like to look at larger populations — dually eligible Medicare and Medicaid users, for example — and tests outside of radiology, to learn more about how these systems are working."