Brookings Institution Study Of HIE Use In Emergency Department Reveals Significant Reduction In Laboratory Tests And Radiology Exams

Results published in Journal of the American Medical Informatics Association and Center for Technology Innovation at the Brookings Institution

Researchers at the Brookings Institution in cooperation with HEALTHeLINK, conducted a pilot study to examine the impact of the use of health information exchange (HIE) technology on reducing laboratory tests and radiology examinations in emergency departments (EDs) at three area hospitals. The results of the pilot, which were recently published in the Journal of the American Medical Informatics Association and the Center for Technology Innovation at Brookings, show a significant reduction in the duplication of tests.

HEALTHeLINK’s clinical liaisons shadowed physicians within the EDs at Kenmore Mercy Hospital, Erie County Medical Center and Buffalo General Medical Center for a six to eight week period last year. A total of 1,450 patients were seen in these three EDs during this period. According to study results, querying HEALTHeLINK’s HIE in the ED setting resulted in a reduction in ordering of laboratory tests and radiology exams.

• In the first ED setting, accessing patients’ information within HEALTHeLINK, led to a 52% reduction in the estimated number of laboratory tests and a 36% reduction in the estimated number of radiology exams.
• In the second ED setting, having clinically relevant patient information resulted in a 25% and 26% reduction in the estimated number of laboratory tests and radiology exams.
• Finally, the third ED setting was associated with a 47% reduction in the estimated number of radiology exams. Querying the HIE in this setting did not affect the total number of laboratory orders as patients were being seen for cardiac and neurovascular issues which require new laboratory tests regardless of past results.

“This study highlights just one component of the value of interoperability and doctors’ access to their patients’ data that HEALTHeLINK and health information technology can provide in improving the quality and efficiency of patient care and enhancing patient safety,” said Dan Porreca, executive director, HEALTHeLINK. “While this study focused on only three emergency department settings, we are hearing from other physicians and medical staff from hospitals and health care organizations throughout Western New York about the benefits of utilizing HEALTHeLINK.”

The goal of the study was to better understand the clinical relevance of HIE and value of patient information in this setting and subsequently increase utilization of HEALTHeLINK based on results. The clinical liaison retrieved any potential clinically relevant information 100% of the time for consented patients. The medical information accessed included previous laboratory results, radiology examinations, hospital admissions and discharge transcripts, operative reports and medication history.

“While direct and indirect costs of these tests can vary by hospital and region, physicians ordering fewer tests because recent pertinent clinical information is available through HEALTHeLINK directly leads to overall costs savings for our local health care community,” added Porreca. “As part of the Statewide Health Information Network of New York (SHIN-NY), the value we provide gets multiplied statewide by other HIE organizations providing similar services within their respective regions. Add to that the ability, via the SHIN-NY, to connect providers across the state and the value grows even further.”

In addition, the study illustrates the importance of efficient workflows to enable providers in ED settings to routinely access HEALTHeLINK for the patients they are treating. For the purpose of this study, clinical liaisons were accessing the information for them on all patients within the designated treatment group. However, post-study the participating hospitals have seen an increase in HEALTHeLINK usage from where they were pre-study.

“With improved usability through continued coordination with hospital IT resources, we expect to see a steady increase toward fully realizing the benefit HEALTHeLINK provides in the EDs and beyond to our local health care community,” concluded David Scamurra, MD, chair, HEALTHeLINK board of directors.

About HEALTHeLINK
HEALTHeLINK, the Western New York Clinical Information Exchange, is a collaboration among the region’s hospitals, physicians, health plans and other health care providers to serve the eight counties of western New York State. HEALTHeLINK was created to enable the exchange of clinical information in secure and meaningful ways to improve both efficiency and quality, while also helping to control health care costs. Patients who provide consent allow physicians and providers directly involved in their treatment to securely access relevant medical information via HEALTHeLINK, resulting in more timely and effective treatment at the point of care.

HEALTHeLINK is part of the Statewide Health Information Network of New York (SHIN-NY), a technology framework spanning the entire state that allows health care providers efficient access to their patients’ data. HEALTHeLINK has been recognized for its work in building a regional health information technology infrastructure and for testing innovative approaches by both state and federal agencies, including being named a Beacon Community, an effort funded by the Office of the National Coordinator for Health Information Technology. For more information, visit wnyhealthelink.com.