A recent research study published in the Journal of the American College of Radiology showed that providers who access patient records through health information exchange (HIE) order fewer repeat X-rays, ultrasounds and other imaging tests, resulting in cost savings. The study was conducted using a cohort of 12,620 patients who underwent imaging procedures during 2009 and 2010. The patients consented to have their information made accessible to providers participating in the Rochester Regional Health Information Organization (RHIO), a non-profit HIE in a 13-county region in western New York State.

Understanding the relationship between accessing patient information in an HIE and imaging costs is critical given imaging procedures constitute a large portion of healthcare expenditures. The federal Medicare program alone spends $10 billion annually on medical imaging, and repeat imaging is a substantial contributor to imaging costs.

HIE system use avoided repeat imaging

In the study, investigators from Weill Cornell Medicine examined the relationship between provider use of HIE and cost savings associated with repeat imaging. Cost savings were estimated by determining the number of potentially avoided repeat imaging studies attributable to HIE system use. The results support the study hypothesis that enabling provider access to existing patient information may lower costs through reductions in repeat imaging.

“Having the actual radiologic images (and not just the report) available on QHN, significantly enhances patient care, noted Dr. Michael Neste, Radiology Medical Director at Colorado Canyons Hospital and Medical Center. “The ordering clinician can now view the images from any personal computer and the “share session” function allows for remote real-time interaction with the radiologist. The ability to exchange images, through the HIE, can also reduce the number of redundant exams that are ordered, which in turn helps contain costs.”

Imaging cost savings support new payment models

The largest portion of estimated savings associated with HIE was attributed to small reductions in repeated advanced imaging procedures, such as CT and MRI. Inexpensive imaging procedures, such as radiography, constituted the largest proportion of avoided repeat imaging studies associated with HIE but accounted for only a small portion of estimated savings. Identifying cost savings attributable to specific imaging modalities will provide insights that allow providers in new payment models to better gauge potential savings from HIE use and develop strategies to help drive efficiency and improved quality of care. 

“QHN is a vital part of my practice it is my means of obtaining pertinent clinical information regarding the patient. With the reimbursement models changing, and I believe as the newer, younger trained physicians join the workforce, the use (of electronic information) will be universal, and we will all wonder what we did before the advent of the EHR and the shared medical record,” continued Neste.