HIEs reduce redundant therapeutic services

Participating in an health information exchange (HIE) “significantly” reduced repetition of therapeutic procedures by providers in western New York, according to research conducted by the State University of New York (SUNY) and the Brookings Institution.

The study, led by SUNY PhD candidate Saeede Eftekhari, compared Medicare claims data to the regional HIE for western New York, HEALTHeLINK, for 122 diagnostic (defined as tests to diagnose or measure the severity of a medical issue) and 149 therapeutic (defined as treatments to help, cure, improve or restore function to a patient) medical procedures that were performed at both participating and non-HIE providers.

As the researchers expected, HIE adoption didn’t have any impact on diagnostic procedures. For therapeutic procedures, however, the study found using a HIE led physicians to avoiding redoing those procedures, which could have a “significant impact on reducing unnecessary repetitions.”

According to an accompanying blog post by Brookings, the study said a physician that performs a specific therapeutic medical procedure 100 times for 73 unique patients repeats the procedure 27 times, an average ratio of repetition of 0.27 After one year of experience with the HIE, the average ratio of repetition for the physician will fall to 0.26—meaning the physician would perform that test 98 times for the same 73 patients, avoiding 2 repetitions.

If those results were expanded to the entire United States, the study said $63 million in Medicare spending could be saved every year for reducing unnecessary therapeutic procedures.

“To the best of our knowledge, prior studies on the outcomes of HIE participation were limited to the emergency departments and therefore our understanding of the outcomes of HIE participation in other settings including physicians’ offices and medical practices was very limited,” Eftekhari and her coauthors wrote. “Our paper bridges this gap in the literature and contributes to the theory by building and testing a set of hypotheses on the benefits of HIE participation on repetition of therapeutic and diagnostic medical procedures at the physicians’ offices.”

With evidence that HIEs can be effective in decreasing costs and improving quality, Eftekhari and her coauthors concluded it would lead to “improved information and data management at HIEs, extended scope and reach of their services to its members, all leading to sustainable HIE business models which seem to be in their infancy at this time.”