Sharing of electronic health record (EHR) information across every major emergency department in the Memphis, TN, area resulted in reduced hospital admissions, reduced radiology tests, and an annual cost savings of nearly $2 million, according to a study in the Journal of the American Medical Informatics Association (November 4, 2011).
The study, led by Mark Frisse, MD, MBA, a professor of biomedical informatics at Vanderbilt University, is the nation's first citywide study of the impact of widespread health information exchange (HIE) data access in emergency departments (EDs).
"This is the first study to show that, on a citywide basis, investments in technology can save medical costs by improving care," Dr. Frisse stated in a university news release. "We took the 'Tennessee simple' approach and built a low-cost system that said, 'Folks, if you do it simply and build it up, doing the right thing can save you money.' "
Patient privacy protection within the system is as rigorous and secure as any commercial electronic health record system, he added.
"It makes available only the information you choose and it can only be used when you are needing care," Dr. Frisse said. "It is far more secure and useful than paper, even if it was all in one place. Health information exchange ensures that we know exactly who has looked at it, when, where and why. So it is accountable to you."
Vanderbilt researchers studied all ED encounters in which HIE data were accessed in all 12 major emergency departments in Memphis over a 13-month period and matched those encounter records with a similar encounter record in which HIE data were not accessed.
Outcomes studied were ED-originated hospital admissions, admissions for observation, laboratory testing, head CT use, body CT use, ankle radiographs, chest radiographs, and echocardiograms.
Clinicians used the technology voluntarily and only when they felt it was necessary for the patient -- about seven in every 100 cases. When HIE data were accessed, it was associated with a significant decrease in CT scans and hospitalizations.
Dr. Frisse sees the study data as being a national model of how to take the first step.
"Emergency department care is such a very small part of our healthcare system, but the same value of complete information realized in emergency department settings is even more applicable when an elderly patient goes to multiple doctors without a single, comprehensive medical record," Frisse said. "It is the first step in showing that if you give physicians the tools to collaborate, they will voluntarily do the right thing for you, and they will save you money and your quality will improve."
