When hospital emergency departments use data accessed through health information exchanges, it results in "net societal saving" with corresponding financial savings as well—mostly through reduced hospital admissions, according to a report posted on the Journal of the American Medical Informatics Association's website
Vanderbilt University researchers studied all instances in which health information exchange data was accessed in the emergency departments of 12 Memphis hospitals over a 13-month period, August 2007 through August 2008, with one hospital—the largest in the study—not gaining health information exchange access until the 10th month of the data collection period. There were 15,798 information exchange encounter records—or about 6.8% of emergency department visits—for 12,120 unique patients, with 9,728 patients (62%) seeking care one time, 1,704 (21%) seeking care twice and 688 (17%) visiting three or more times.
Researchers looked at emergency department-originated hospital admissions, admissions for observation, laboratory testing, head CT use, body CT use, ankle radiographs, chest radiographs and echocardiograms. Having information accessible from a health information exchange resulted in annual total savings of $1.95 million, the researchers calculated, with 97.6% of this amount coming from reduced admissions. Calculating that operational costs of the information exchange were around $880,000, this resulted in net savings of about $1.07 million.
There were 191 fewer hospitalizations associated with access to the information exchange data at the 11 hospitals that had access all 13 months, and 221 fewer at the largest hospital that gained access only in the 10th month. Also, although information exchange access was said to result in fewer head and body CT scans and lab tests at the large hospital, it was associated with more chest radiographs and head CTs at the smaller facilities.
Dr. Kevin B. Johnson, a Vanderbilt professor and vice chairman of biomedical informatics and the study's lead evaluator, said this last finding is not what researchers expected and could be related to emergency department physicians wanting confirmation of previous findings or checking to see whether a patient's condition has changed. He added that a larger, national study was needed to evaluate physician decision-making in the emergency department—noting that, in trauma cases, the first instinct is to address the trauma before analyzing records.
Johnson also said the researchers "actually low-balled financial estimates" and said that if data were collected now, he'd expect the savings to be higher.