What We Learned Researching The Implementation Of A Health Information Exchange

A Health Information Exchange provides access to valuable and timely information that emergency department physicians need to deliver better care.

Emergency departments are notoriously busy places that can often see their efficiency dip as staff attempts to maintain the quality of care for patients. However, these two goals don’t have to be mutually exclusive as a recent study of the Health Information Exchange (HIE) that was adopted by the state of New York pointed out.

1. Better Patient Outcomes and Reduced Costs

According to the study, which examined nearly 86,000 encounters at four emergency departments that were integrated with the HealthLinkNY Health Information Exchange, both operational efficiency and quality of care were improved. The result was that an increase in positive patient outcomes, as well as cost savings, were realized.

2. Saves Physicians Time

A co-author of the study, Assistant Professor of Operations and Supply Chain Management at the School of Management at SUNY Binghamton, Dr. Emre Demirezen, PhD, noted that the ability to save an emergency room physician time was a crucial benefit of using a HIE. As he pointed out if the emergency physician attending a particular patient had a question. It is possible that the information needed to deliver good care was already stored in the patient’s medical record. Having access to these answers by being able to view patient records saves time. There is no need to call out to the patient’s physician or to wait for external verification if the required information can be obtained utilizing the HIE.

3. Adoption of HIE Allows for Shorter Emergency Room Stays for Patients

According to the study, which looked at 326 physicians who attended 46,270 patient visits over a 19-month period of time, the length of stay in the emergency room fell by more than seven percent. While the average duration of stay was 22 hours and 23 minutes, using the HIE caused it to fall to 20 hours and 48 minutes. This reduction was attributed to the ability of the HIE to allow physicians to access the information they need to identify underlying causes as well as any conditions that could contribute to the condition of the patient. Another reason that was cited as being responsible for the drop in stays is that the HIE reduces the need for duplicate testing.

4. Reduces the Risk of Readmission

Another conclusion the study found is that the ability to access patient records utilizing the HIE helped reduce the incidences of readmission. This reduction was examined over a time frame of 30 days from discharge with the odds of readmission to any emergency department — both the original facility as well as any other — falling by 4.5 percent. A comparison of a 60-day period after discharge showed consistent numbers as well.

5. Fewer Physicians Need to be Involved in Care

Patients that arrive in the emergency room sometimes present with symptoms and conditions that are outside the attending physician’s expertise. To deliver the optimum in care, a specialist is often either consulted or called into the hospital to evaluate the patient. Using the HIE allows the attending physician to scrutinize the patient’s history as well as any recent encounters they might have experienced regarding any of their conditions. This can reduce the need for a consultation with the specialist and streamline the patient’s experience.

As Dr. Demirezen noted, learning how to use the HIE takes time and effort. When physicians do so, however, they have better outcomes as they become more comfortable with it. It is expected that doctors, patients, and payers will continue to experience improved efficiencies over time.

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Author: Aaron White, Date: 9th May 2017