AHRQ Study Shows Use of HIE Decreases Repeat Imaging in Emergency Departments
Using health information exchange (HIE) can decrease repeated diagnostic imaging for back and head pain, according to research supported by AHRQ. Researchers analyzed cases from Memphis area emergency departments to better understand the impact of HIE on repeated x-rays, CT scans, and other radiological studies. Doctors, nurses and other clinicians working in ERs did not frequently look up results through the HIE. However, when they did use the system to obtain prior results, there was a significant reduction in repeat testing. The study suggests that more research is needed to assess strategies to encourage providers to routinely access HIEs to determine if prior test results are available. “Health Information Exchange Reduces Repeated Diagnostic Imaging for Back Pain” appeared in the July issue of Annals of Emergency Medicine. Select to access the abstract on PubMed.®
Ann Emerg Med. 2013 Jul;62(1):16-24. doi: 10.1016/j.annemergmed.2013.01.006. Epub 2013 Mar 7.
Health information exchange reduces repeated diagnostic imaging for back pain.
SourceDivision of General Internal Medicine, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN. Electronic address: firstname.lastname@example.org.
STUDY OBJECTIVE:This study seeks to determine whether health information exchange reduces repeated diagnostic imaging and related costs in emergency back pain evaluation.
METHODS:This was a longitudinal data analysis of health information exchange patient-visit data. All repeated emergency department (ED) patient visits for back pain with previous ED diagnostic imaging to a Memphis metropolitan area ED between August 1, 2007, and July 31, 2009, were included. Use of a regional health information exchange by ED personnel to access the patient's record during the emergency visit was the primary independent variable. Main outcomes included repeated lumbar or thoracic diagnostic imaging (radiograph, computed tomography [CT], or magnetic resonance imaging [MRI]) and total patient-visit estimated cost.
RESULTS:One hundred seventy-nine (22.4%) of the 800 qualifying repeated back pain visits resulted in repeated diagnostic imaging (radiograph 84.9%, CT 6.1%, and MRI 9.5%). Health information exchange use in the study population was low, at 12.5%, and health care providers as opposed to administrative/nursing staff accounted for 80% of the total health information exchange use. Health information exchange use by any ED personnel was associated with reduced repeated diagnostic imaging (odds ratio 0.36; 95% confidence interval 0.18 to 0.71), as was physician or nurse practitioner health information exchange use (odds ratio 0.47; 95% confidence interval 0.23 to 0.96). No cost savings were associated with health information exchange use because of increased CT imaging when health care providers used health information exchange.
CONCLUSION:Health information exchange use is associated with 64% lower odds of repeated diagnostic imaging in the emergency evaluation of back pain. Health information exchange effect on estimated costs was negligible. More studies are needed to evaluate specific strategies to increase health information exchange use and further decrease potentially unnecessary diagnostic imaging and associated costs of care.
Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
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