HIE Study Finds That Failure To Use Data Cost $1.3 Million Over 18 Months

Posted on March 3, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

You can put an HIE in place, but you can’t make doctors drink. That fractured moral was demonstrated recently by an HIE in Western New York, which found that many doctors were failing to use data available in the HIE, and thus ordering CT scans that were unnecessary — wasting about $1.3 million over an 18 month period.

The HIE, HEALTHeLINK, recently conducted a study intended to put a specific value on how many potentially unnecessary duplicative tests were being ordered by providers in its region, as well as a potential savings to the health system.

The sample audience was comprised of patients who had received more than one CT scan within a six-month period on the same part of the body. Scans were then sorted into the three most common categories of CBT groupings — head and neck, chest, and abdomen.

The duplicate scans were divided into three separate categories: 1) studies in which the CT report clearly reference to previous CT scan, 2) inconclusive studies in which researchers were able to tell if the previous study was known prior to ordering the scan and 3) unknown studies in which the CT report clearly stated that no previous study was known of.

Some findings include the following:

* During the 18 month study, which drew on claims data from three major insurance carriers in the area, researchers found about 2,763 CT scans which were considered to be potentially unnecessary.

* About 90 percent of the potentially needless CT scans were ordered by physicians who never or infrequently used the HIE. And more than 95 percent of the identified potentially unnecessary CT scans were done in a hospital,

* About 50 percent of the patients who had a duplicate CT scan had already consented to have their data accessed (so patients weren’t the obstacle).

While the analysis is complex, the lesson seems to be fairly simple. HIE’s are missing out on producing cost reductions when doctors aren’t accessing them prior to ordering tests.