Does health information exchange reduce redundant imaging? Evidence from emergency departments.
Med Care
; 52(3): 227-34, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24374414
ABSTRACT
BACKGROUND:
Broad-based electronic health information exchange (HIE), in which patients' clinical data follow them between care delivery settings, is expected to produce large quality gains and cost savings. Although these benefits are assumed to result from reducing redundant care, there is limited supporting empirical evidence.OBJECTIVE:
To evaluate whether HIE adoption is associated with decreases in repeat imaging in emergency departments (EDs). DATA SOURCE/STUDYSETTING:
ED discharge data from the State Emergency Department Databases for California and Florida for 2007-2010 were merged with Health Information Management Systems Society data that report hospital HIE participation.METHODS:
Using regression with ED fixed effects and trends, we performed a retrospective analysis of the impact of HIE participation on repeat imaging, comparing 37 EDs that initiated HIE participation during the study period to 410 EDs that did not participate in HIE during the same period. Within 3 common types of imaging tests [computed tomography (CT), ultrasound, and chest x-ray), we defined a repeat image for a given patient as the same study in the same body region performed within 30 days at unaffiliated EDs.RESULTS:
In our sample there were 20,139 repeat CTs (representing 14.7% of those cases with CT in the index visit), 13,060 repeat ultrasounds (20.7% of ultrasound cases), and 29,703 repeat chest x-rays (19.5% of x-ray cases). HIE was associated with reduced probability of repeat ED imaging in all 3 modalities -8.7 percentage points for CT [95% confidence interval (CI) -14.7, -2.7], -9.1 percentage points for ultrasound (95% CI -17.2, -1.1), and -13.0 percentage points for chest x-ray (95% CI -18.3, -7.7), reflecting reductions of 44%-67% relative to sample means.CONCLUSIONS:
HIE was associated with reduced repeat imaging in EDs. This study is among the first to find empirical support for this anticipated benefit of HIE.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Diagnóstico por Imagem
/
Continuidade da Assistência ao Paciente
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Serviço Hospitalar de Emergência
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Registros Eletrônicos de Saúde
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Med Care
Ano de publicação:
2014
Tipo de documento:
Article