Emergency patients benefit when medical records shared

As hospitals and doctors’ offices across the country race to join online systems that let them share medical information securely, a new study suggests that these systems may already be helping cut unnecessary care.

Fewer emergency patients got repeated medical scans when they went to a hospital that takes part in a health information exchange, or HIE, according to new findings by University of Michigan researchers published online in the journal Medical Care.

UMSI assistant professor Julia Adler-Milstein was a member of the study team, which was headed by Keith Kocher, M.D., a U-M emergency room physician.  Kocher also worked with Eric Lammers, Ph.D., who performed the analysis for his doctoral work at the U-M School of Public Health and is now working at Mathematica Policy Research.

Although the study focuses specifically on scans done on patients who went to two different emergency departments in a 30-day period, the authors say the findings serve as a good test case for the effectiveness of HIEs. The study is one of the first to show with hard data that HIEs may deliver the increased efficiency they promise.

The researchers chose to examine emergency care, says Kocher, because emergency department teams need information quickly in order to diagnose and treat a patient.

The ability to log in to a computer and pull up that patient’s previous records from other hospitals through an HIE -- instead of ordering duplicate tests or scans -- holds great promise, he says. But until now, large-scale studies haven’t been done.

The findings show that the use of repeat CT scans, chest X-rays and ultrasound scans was significantly lower when patients had both their emergency visits at two unaffiliated hospitals that took part in an HIE. The data come from two large states that were among the early adopters of HIEs: California and Florida.

Patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get a duplicate ultrasound, and 67 percent less likely to have a repeated chest X-ray when both their emergency visits were at hospitals that shared information across an HIE.

“The emergency department is an important test case for whether we would see any impact from HIEs on rates of repeat imaging,” says Lammers. “The fact that we find that there is a decrease is in and of itself significant.”

The research was supported by the U-M STIET doctoral training program, which Lammers participated in, and the Health Services Organization and Policy doctoral training program.

Courtesy of the University of Michigan Health System media services. Read the full release here.

Posted on Friday, January 24, 2014