The Value of Health Information Exchange

Health information exchange (HIE), the sharing of clinical and administrative data across the boundaries of healthcare institutions and other health data repositories, is imperative to recent efforts to achieve the Triple Aim of healthcare: improving care for individuals, bettering health for populations, and reducing costs.

Many stakeholder groups (payers, patients, providers, and others) realize that if such data are shared, healthcare processes would improve with respect to safety, quality, cost, and other indicators.

Explore recent examples showcasing the value of health information exchange including the Statewide Health Information Exchange for New York (SHIN-NY)

 

HealtheConnections


Video time: 2 minutes and 36 seconds

Learn more.

HEALTHeLINK


Video time: 1 minute

Learn more.

Healthix


Video time: 2 minutes and 7 seconds

Learn more.

HealthlinkNY


Video time: 4 minutes and 52 seconds

Learn more.

Hixny


Video time: 3 minutes and 49 seconds

Learn more.

 


 

SHIN-NY HIE Value Studies

Do Health Information Exchanges Deter Repetition of Medical Services?

SSRN | May 22, 2017

The purpose of this study was to assess the extent to which health information exchange (HIE) could reduce repetitions of two classes of medical procedures (diagnostic and therapeutic) in an office setting. Analysis shows that a practice’s tenure with HIE significantly lowers the repetition of therapeutic medical procedures, while diagnostic procedures are not impacted. The access to previous medical information provided by a HIE leads to the reduction in duplicate testing, which can ultimately save money.

View article.

Hospitalization Event Notifications and Reductions in Readmissions of Medicare Fee-for-Service Beneficiaries in the Bronx, New York

Journal of the American Medical Informatics Association | October 7, 2016

Preliminary findings from an analysis of the subscription alert services offered by the Bronx Regional Health Information Organization and a survey of their participating organizations with subscription services found that subscriptions alerts were associated with a 2.9% reduction in the odds that a hospitalized patient would be readmitted within 30 days of discharge. Alert services were associated with saving $2 million in potentially avoided readmission costs in the Bronx for Medicare fee-for-service beneficiaries over a three-year period.

View article.

Health Information Exchange in the Wild: The Association Between Organizational Capability and Perceived utility of Clinical Event Notifications in Ambulatory and Community Care

Journal of the American Medical Informatics Association | April 23, 2016

Preliminary findings from a survey of Bronx Regional Health Information Organization participating organizations with subscription services found healthcare organizations with appropriate processes, workflows, and staff may be better positioned to use event notifications. Supportive organizational policies were associated with the perception that event notifications improved quality of care, efficiency, and patient satisfaction. Higher quality of event notification information was also associated with a perceived positive impact on quality of care, efficiency, and patient satisfaction.

View article.

An Empirical Analysis of the Financial Benefits of Health Information Exchange in Emergency Departments

Journal of the American Medical Informatics Association | June 27, 2015

A pilot study to examine the impact of the use of health information exchange technology on reducing laboratory tests and radiology examinations in three Western New York EDs supported by HEALTHeLINK found significant utilization reductions. In the study, access to the HIE platform was provided to all of the patients in a treatment group, while the care of those in the control group did not include querying an HIE platform. In one of the ED settings, querying the HEALTHeLINK database was associated with a 52% and 36% reduction in the estimated number of laboratory tests and radiology examinations, respectively. The results indicate that access to additional clinical data through the HIE will significantly reduce the number of laboratory tests and radiology examinations performed in the ED settings and thus support the ongoing HIE efforts.

View article.

Health Information Exchange and the Frequency of Repeat Medical Imaging

American Journal of Managed Care | November 20, 2014

Use of the Rochester RHIO HIE system to access previous patient information was associated with a reduction in repeated imaging. HIE system access reduced the adjusted odds of a repeat image by 25%. Of 196,314 patients in the cohort, 34,604 (18%) of patients had at least 1 imaging procedure, which was equivalent to a rate of 28.7 imaging procedures per 100 patients. Overall, 7.7% of images were repeated within 90 days. If the HIE system was accessed within the 90 days following an initial imaging procedure, imaging was significantly less likely to be repeated (5% repeated with HIE access vs 8% repeated without HIE access, P < .001).

View article.

The Potential for Community-Based Health Information Exchange Systems to Reduce Hospital Readmissions

Journal of the American Medical Informatics Association | August 4, 2014

Accessing patient information in the Rochester RHIO HIE system in the 30 days after discharge was associated with a 57% lower adjusted odds of readmission over a six-month period. The estimated annual savings in the sample from averted readmissions associated with HIE usage was $605,000. These findings indicate that usage of an electronic HIE system in the ambulatory setting within 30 days after hospital discharge may effectively prevent hospital readmissions, thereby supporting the need for ongoing HIE efforts.

View article.

Local Public Health Efforts Bolstered by Use of Health Information Exchange

HEALTHeLINK | July 21, 2014

The Erie County Department of Health (ECDOH) noticed significant improvements in tracking overall public health efforts, specifically as it pertains to sexually transmitted diseases (STD) surveillance, treatment, and prevention, when they partnered with HEALTHeLINK.

The secure access to public health statistics and other data provides public health practitioners with important and timely information and helps focus the attention of healthcare resources and education.

These efficiencies have led to a reduction in time that it takes for disease intervention specialists to identify treatment requests, cases, and contacts. ECDOH epidemiology staff and disease intervention specialists use HEALTHeLINK to access lab, radiology, medication, and demographic data to determine if appropriate STD treatment is administered and to monitor demographic and contact information on STD cases and their partners.

View article.

Association Between use of a Health Information Exchange System and Hospital Admissions

Applied Clinical Informatics | April 12, 2014

The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding. The annual savings in the sample was $357,000.

View article.

HIE Resources

Health Information Exchange Associated with Improved Emergency Department Care Through Faster Accessing of Patient Information from Outside Organizations

Journal of the American Medical Informatics Association | August 11, 2016

Study provides conclusive evidence that HIE can improve a diverse set of meaningful ED outcomes through faster access to information from outside organizations. For the 437 patients for whom HIE was used, more timely access to outside information saved 385 hours of patient time in the ED. Similarly, improved timeliness was associated with avoiding CT for 11 patients who would have otherwise with have received at least 1, MRI for 7 patients, radiograph for 11 patients, and admission for 11 patients. Finally, improved timeliness was associated with a reduction of $519,000 in charges. Provider organizations are therefore likely to benefit from investing in forms of HIE and associated workflows that ensure that ED clinicians can view information from outside organizations in a timely manner.

View article.

Using Health Information Exchanges to Calculate Clinical Quality Measures: A Study of Barriers and Facilitators

Healthcare | May 26, 2016

Health information exchanges (HIEs) have emerged to facilitate exchange of clinical data across provider organizations and, therefore, should be well-positioned to support clinical quality measure reporting. This study sought to assess the extent to which HIEs can provide such reporting and barriers they face. Findings show the ability to compute clinical quality measures (CQMs) at the HIE level is still yet to be developed; currently, very view HIEs are able to do so for a variety of reasons. As HIE services expand and HIEs mature organizationally, the viability and utility of CQM reporting at the HIE level will increase. Structural and organizational factors, maturity, data quality, sustainability, policies, best practices, and vendor relationships all play an important role in the ability of HIEs to compute meaningful CQMs.

View article.

Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems' Enterprise Health Information Exchanges

The Milbank Quarterly | March 2016

Health information exchange is a tool to support better care and respond to policies aimed at encouraging population health management approaches. Although not an either/or decision, the reasons to participate in a community HIE and to establish an enterprise HIE are markedly different, as are the potential advantages and implications of each.

While potentially complementary, community and enterprise HIE are competing for the same organizational resources and stakeholders. Furthermore, current health policies create a stronger business care for enterprise HIE. To ensure that the public benefits from a community-wide health information exchange among all providers, community HIEs may require public funding and supporting regulation to ensure their continued sustainability and service delivery.

View article.

Finding the Value in Health Information Exchange: Part II

HIMSS | December 7, 2015

HIMMS developed a robust tool called the Health IT Value Suite, a framework and vocabulary that can help organizations better understand their value strategy. This platform also hosts hundreds of real-world examples of how health IT has demonstrated value from several healthcare stakeholders (e.g. hospital, physician, HIE, ACOs, etc.). This blog series focused on the finding the value in HIE.

This post outlines powerful ‘statements of value’ in three categories: treatment and clinical, electronic secure data, and patient engagement and population management. These statements help demonstrate why health information exchange capabilities are critical to fulfilling the triple aim of healthcare: healthier communities, lower healthcare costs, and higher quality patient care and satisfaction.

View article.

Finding the Value in Health Information Exchange: Part I

HIMSS | November 19, 2015

HIMMS developed a robust tool called the Health IT Value Suite, a framework and vocabulary that can help organizations better understand their value strategy. This platform also hosts hundreds of real-world examples of how health IT has demonstrated value from several healthcare stakeholders (e.g. hospital, physician, HIE, ACOs, etc.). This blog series focused on the finding the value in HIE.

At the highest level, health information exchange provides a technical capability that enables many crucial benefits for providers, patients, and hospitals, including:

  • Enhanced care coordination through communication between providers;
  • Ensuring access to the right information, at the right time, for providers (including the entire care team), patients and all other stakeholders. HIE is central to facilitating the information to both patients and their loved ones;
  • Improving efficiency and reliability through the elimination of unnecessary paperwork and providing caregivers with clinical decision support tools; and
  • Improving quality and safety through the reduction of medication, medical errors and near misses.

View article.

Health Information Exchange Readiness for Demonstrating Return on Investment and Quality of Care

Perspectives in Health Information Management, AHIMA Foundation | Fall 2015

This study aimed to provide a snapshot of the extent to which community HIEs are delivering or employing metrics to demonstrate return on investment (ROI) and improvements in the quality of care. Based on the survey conducted, respondents from most community HIEs believe their HIEs are demonstrating a positive ROI. This suggests that even with the proliferation of HIEs supported by both the HITECH Act and the increased use of HIEs by health systems, evidence about the ability of HIEs to achieve a positive ROI is still lacking.

Similarly, community HIE respondents overwhelmingly report that they believe their HIEs’ activities improve the quality of healthcare delivered, but only a small minority are actually using data to evaluate provider performance or generate reports on quality measures.

View article.

Washington State Medicaid: Implementation and Impact of “ER is for Emergencies” Program

The Brookings Institution | May 4, 2015

The “ER is for Emergencies” program was developed through a collaborative effort between the Washington State American College of Emergency Physician, the Washington State Medical Association, and the Washington State Hospital Association. Driven by concerns about costs associated with high ED use, this plan started in 2012 to improve management of emergency department (ED) conditions and address overutilization through “seven best practices” that include interoperable health information exchange (HIE) technology referred to as the Emergency Department Information Exchange (EDIE), patient education on appropriate ED use, identification of frequent users of the ED and prehospital care, development of patient care plans, implementation narcotic guidelines, participation in prescription monitoring program, and use of feedback information.

EDIE integrates into existing ED electronic health records (EHR) to push basic information about resource utilization to providers such as past visit dates and chief complaints. In addition, EDIE includes a prescription management program and clinical pathways. For high utilizing patients, EDIE also includes care plans and case managers to work individually to follow-up with patients after discharge and help connect them to outside resources.

The ER is for Emergencies program is able to integrate the entire state with robust utilization to break down barriers between institutions and streamline information delivery. In the first year of the program, Medicaid ED costs fell by nearly $34 million through a reduction in ED visits. ED visits by Medicaid patients declined by nearly 10%, with rates of visits by high utilizers (5+ visits/year) declining by approximately 11%. For less serious conditions, the visit rate decreased by more than 14% over the year.

Finally, visits resulting in the prescription of controlled substances fell by 25% for the Medicaid population. While this program may have helped avoid less effective payment reductions affecting emergency departments, sustaining and expanding such programs may require further payment changes to enable emergency departments to share in the overall savings from initiatives like this one.

View article.

The Financial Impact of Health Information Exchange on Emergency Department Care

Journal of the American Medical Informatics Association | May-June 2012

Thirteen emergency departments in Memphis, Tennessee were examined to determine the direct financial impact by determining how HIE data access by emergency departments physicians affected hospital admissions and diagnostic testing. Results show that, applied only to the study population, HIE access was associated with an annual cost savings of $1.9 million. Net of annual operating costs, HIE access reduced overall costs by $1.07 million. Hospital admission reductions accounted for 97.6% of total cost reductions.

View article.

Health information exchange -- HealthIT.gov

The demand for electronic health information exchange from one health care professional to another is growing along with nationwide efforts to improve the quality, safety and efficiency of health care delivery. Meaningful use requirements, new payment approaches that stress care coordination, and federal financial incentives are all driving the interest and demand for health information exchange.

View article.

 


 

Value of HIE for Patients

Most patients receive medical care from more than one doctor, practice, or hospital. Even with relatively simple healthcare needs, keeping track of and coordinating information among doctors can be a daunting task.

Health information exchange (HIE) allows the electronic sharing of health data, ensuring doctors, with patient consent, have access to the most accurate and up-to-date information about patients’ health and treatment history.

There is value in healthcare providers having a single, centralized health record that can be accessed at any location patients receive care. New York State is at the forefront of health information exchange. The Statewide Health Information Network for New York (SHIN-NY) creates a secure, statewide network of electronic health records designed to improve healthcare for all New Yorkers by ensuring that doctors have instant and accessible information about their patients, anywhere and anytime.

 


 

To submit additional recent examples showcasing the value of HIE for consideration for inclusion, please contact us.