HIE access cuts ED radiology exam rates by as much at 47%

Many have touted the expansion of health information exchanges (HIEs) as a method of cutting the rates of unnecessary imaging and redundant exams, and results of a recent study suggest these investments are not going to waste.

A report featuring results of trials in two Western New York emergency departments (EDs) served by an HIE showed significant drops in the amount of radiology exams conducted when the patient data was accessed through the HIE, according to the Brookings Institution.

The trials were conducted by HEALTHeLINK, the regional health information organization (RHIO) that provided the query-based HIE service, and the report was prepared by Brookings Institution fellow Niam Yaraghi. Medical liaisons who were trained in accessing the RHIO’s database were stationed in the two EDs and while they did not interfere with the treatment process, they informed ED providers about patient medical information that was available on the HIE.  

In the first trial, conducted from Aug. 4 to Sept. 26, 2014, 449 patient visited the ED when the liaisons were present and 399 patients were treated in the same ED when the liaisons were not present, meaning the database was not queried for these patients.

Results showed a 26 percent reduction in the estimated number of radiology exams when the liaisons were able to access patient information to help inform care.

The impact of the HIE was even more pronounced in the second trial, conducted from Oct. 20 to Dec. 8, 2014. In that ED, in which 303 patients were treated while the medical liaisons were present and 418 were treated by the same clinicians when the liaisons were not present, access to the HIE was associated with a 47 percent drop in the number of radiology exams.

Yaraghi noted that the results highlight the importance of routinely incorporating HIE access into workflows when such databases are available.

“The rate of access to HIE platforms in the treatment group was artificially held at 100 percent and is considerably above the typical HIE access rates in other ED settings. This was made possible by hiring liaisons who were only focused on querying and filtering RHIO’s database and provided the clinicians with the relevant medical data,” he wrote. “The results of this study enables other ED settings to evaluate the benefits of increasing their HIE querying rate against its potential costs.”

Over the past decade, the Office of the National Coordinator for Health IT has awarded more than half a billion in grants to states to develop HIEs, according to Yaraghi.