HIEs may still be struggling commercially — to my knowledge nobody’s found a business model that works without big subsidies — but data is coming in to suggest that they can have a major impact nonetheless. That seems to be the case in Memphis, where a study concluded that the local HIE saved $2 million by significantly reducing readmissions.
The study, which appears in the Journal of the American Medical Informatics Association this month, looked at a 13-month stretch during which emergency physicians at 12 hospitals had access to patient information through an HIE. The hospitals are all members of the the MidSouth eHealth Alliance, which runs the HIE.
To determine what effect the HIE was having, researchers examined every ED encounter that happened between July 2007 and September 2008 that involved the use of HIE data. All told, the researchers ended up crunching numbers for 15,798 HIE-related encounters. They then paired that data with an equal number of non-HIE-using encounters to look for differences.
One of the most interesting datapoints to be found here was that reduced admission levels for the 12 hospitals accounted for 97.6 percent of the $2 million in savings. That’s a remarkable number, though it does leave me wondering whether the patients did equally well on other outcomes measures.
Even more interesting was that these results come from a relatively small number of ED encounters. ED physicians weren’t required to use the HIE, only accessed it about 6.8 percent of the time. You’ve got to wonder what would happen if ED doctors used the HIE most of the time.
Having learned all of this, here’s hoping the researchers dig in to other measures of care quality. For example, do ED physicians make fewer mistakes when they use HIE data? Do they order fewer tests, or perhaps more given that they know more about patient needs?
This is a promising study. Now let’s see someone compare the financial and technical models for HIEs and tell us which, if any, are proving themselves.
