HIE Cuts Back On Excess Imaging, But Savings Aren’t Huge

Posted on January 21, 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.

For years now, we’ve been told that HIEs would save money and reduce redundant testing by hospitals and doctors.  Until recently, such has mostly been the stuff of anecdote rather than hard results.  But a new study comparing hospitals on an HIE with those that were not seems to offer some of the hard evidence we’ve been waiting for (though the cost savings it finds aren’t spectacular overall).

According to a piece in Healthcare IT News, a new study has come out which demonstrates a link between HIE participation and the level of imaging performed in hospital emergency departments.

The study, which was done by Mathematica Policy and the University of Michigan, found that when hospitals were joined in an HIE, the number of redundant CT scans, x-rays and ultrasounds fell meaningfully, generating savings in the millions of dollars.

To conduct the study, Mathematica and the U of Michigan compared the level of repeat CT scans, chest x-rays and ultrasounds for two groups.  One group consisted of 37 EDs connected to an HIE; the other group was 410 EDs not connected to an HIE.  Researchers collected data on the two groups, which were based in California and Florida, between 2007 and 2010, using the state emergency database and HIMSS Analytics listing of hospital HIE participation.

The researchers found that hospital EDs participating in an HIE reduced imaging across all the modalities compared with hospitals not participating in an HIE.  For example, EDs using an HIE worth 13 percent less likely to repeat chest x-rays, and 9 percent less likely to repeat ultrasounds.

Ultimately, the study concluded that if all of the hospital EDs in California in Florida were participating in HIEs, the two states could save about $3 million annually by avoiding repeat imaging.  This is just fine, but this translates to $3 million in lost revenue for those hospitals. Once you split up $3 million across that many hospitals, you don’t end up with an impressive amount per hospital, but it’s still a cut to revenues. A cut in revenue isn’t a strong motivator to implement an HIE even if it does help to lower healthcare costs.

This is why it’s a real challenge to get many hospitals on an HIE. When you throw in the technical issues involved in HIE membership, it could be quite some time before the majority of hospitals jump on board without more external incentives.