A study released by Harvard researchers that concluded that physicians who have computerized access to patients' test results are more likely to order additional lab and imaging tests has a new counterpoint by another team of Harvard researchers.
A three-page research letter, "Bridging the Chasm: Effect of Health Information Exchange on Volume of Laboratory Testing" (purchase required), published in the March 26 issue of the Archives of Internal Medicine, reports on a study that examined outpatient visits at two affiliated academic hospitals one year before and up to three years after a health information exchange was rolled out.
The study looked at 117,606 outpatient encounters at the two hospitals. The encounters occurred in 1999, the year before a health information exchange between them was rolled out, and in the years 2001 through 2004, when the HIE was in operation. Before and after the exchange's implementation, the researchers counted the number of laboratory tests ordered at either of the hospitals that occurred seven or fewer days before an outpatient visit at the other hospital, which the researchers call an "index encounter." Between the two study periods, before and after the exchange's implementation, 346 visits in which lab results were available from the "other" hospital took place.
After introduction of the information exchange, the number of lab tests performed after those encounters that had involved recent off-site lab tests decreased by 49% to 53%, depending on the type of statistical analysis performed, the researchers reported.