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Health information exchanges will cut back—way back—on duplicative imaging for patients who make repeat visits to emergency rooms, suggests a study published online last month in Medical Care.

University of Michigan researchers looked at the rates of repeat scans for patients who went to two different, unaffiliated emergency departments within 30 days. When both visits were at hospitals that shared information via an HIE, the study found, patients were:

  • 59 percent less likely to have a duplicative CT scan;
  • 44 percent less likely to have a duplicative ultrasound;
  • 67 percent less likely to have a duplicative chest X-ray.

Keith Kocher, MD, an emergency physician at the University of Michigan Medical School, said the results were significant:

Our data allowed us to study a very specific type of care where HIE was associated with reducing what would potentially be a redundant test by half, which we think is pretty meaningful.

Dr. Kocher was senior author of the study. He was quoted in a university news release.

The researchers couldn’t actually tell whether doctors in the second emergency room had accessed the HIE—only that it would have been possible for them to have done so.

“We can’t say yet how generalizable these results will be to other settings,” Dr. Kocher said, “but these are definitely interesting empirical findings.”

Eric Lammers, PhD, performed the analysis while doing doctoral work at the University of Michigan School of Public Health. He said, “The emergency department is an important test case for whether we would see any impact from HIEs on rates of repeat imaging. The fact that we find that there is a decrease is in and of itself significant.”

The federal government is using financial incentives to push HIEs, and electronic health records in general. “There has been a lot of hope, and some hype, that these systems will enable more efficiency in how care is provided across unaffiliated providers,” Dr. Lammers said.

Apparently, at least some of the hope, and hype, have been justified.

Related CME seminar (up to 20 AMA PRA Category 1 credits™): Emergency Radiology


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