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A recent study of the Health Information Exchange adopted in New York State has shown the value of investing in an HIE and the positive impact it has on patient outcomes and operational efficiency.
Following considerable investment in the New York State HIE, patient stays have been reduced, the likelihood of readmission has fallen, as have the number of physicians needed to examine patients in emergency departments. The study has shown that quality of care has been improved along with operational efficiency, resulting in considerable cost savings and improved patient outcomes.
The study examined almost 86,000 emergency department encounters over a period of 19 months between July 1, 2012 and January 31, 2014 at four emergency departments linked to the HealthLinkNY Health Information Exchange.
During that time, there were 46,270 patient visits which were attended by 326 physicians. Emergency departments were selected for the study as they are high pressure environments where physicians are required to treat patients with a wide range of medical conditions and must gather information on patients as quickly as possible.
Dr. Demirezen, Assistant Professor of Operations and Supply Chain Management at SUNY Binghamton’s School of Management, was a co-author of the study. He explained one of the key benefits of the HIE was the amount of physicians’ time that was saved, “If the attending physician has a question, the answer might already exist in the patient’s medical record. Looking up the record in the HIE saves a lot of time.”
The study focussed on three areas to measure efficiency and healthcare delivery quality:
Length of stay;
Readmission risk; and,
Number of doctors seen by each patient.
The study showed that following the adoption of the HIE there was a 7.04% decline in length of stays, a 4.5% reduction in the likelihood of readmission within 30 days, and a 12% drop in consultations by multiple physicians.
The average length of stay fell from 22 hours and 23 minutes to 20 hours and 48 minutes. The fall was explained by the reduction in the need for duplicate tests to be performed and the HIE allowing physicians to access information that can help them identify underlying causes and complications that could be contributing to patients’ condition.
Readmission rates were studied over a period of 60 days following discharge. The study looked at readmission to other healthcare facilities in the state, not just the emergency department where the patient was treated.
Physicians who encounter patients with medical conditions outside their area of expertise usually call on a specialist to evaluate the patient. However, access to the HIE allows physicians to check recent encounters with other physicians and specialists, reducing the need to call on specialists for second opinions in an emergency department setting.
It can take time for physicians to get used to using the HIE, but over time efficiency improves and they get better outcomes with experience. Dr. Demirezen said “The conclusion we drew is that providers should actively promote and support clinician use of the HIE and invest time and effort into training them on its use,”
Christina Galanis, President and CEO of HealthlinkNY, explained the significance of the results of the ground-breaking study and the benefits of implementing an HIE, “Now providers have the evidence they need to make HIE use a priority for their organizations. The study proves that New York State’s visionary investment in HIEs is really paying off.”