Meaningful use requirements are increasingly expected to prompt more practical use of electronic health record systems as the rote implementation guidelines of stage 1 are expanded upon with the more comprehensive ones of stage 2. The Centers for Medicare and Medicaid Services has made it clear that physicians and other health care professionals will be expected to utilize EHR systems as an active medical tool rather than a vehicle for meaningful use incentives.
A recent study by Cornell University researchers, published in the journal Applied Clinical Informatics, may indicate the pragmatic value of EHR information stored in widely accessible health information exchanges. When emergency room physicians consulted a patient's medical history through an HIE, the study concluded, the rate of admissions was reduced by 30 percent.
Checking patient histories
Joshua Vest, assistant professor at Weill Cornell Medical College, was lead author on the study that looked at the ER visits of 15,645 adults in New York who had submitted their medical histories for use in an HIE run by the Rochester Regional Health Information Organization. When the study participants came into the ER and their physicians consulted an HIE for further information, 30 percent fewer patients were admitted for observation and testing.
Comprehensive medical histories in easily accessible HIE systems may provide physicians with results from tests that were run at other hospitals in the past. Unnecessary testing and admissions place a tremendous financial strain on the health care industry and a physical toll on physician workflows. Avoiding repetition of tests for which the results are already available could save time and money for physicians and patients alike.
In the Cornell study, the hospitals in question saved nearly $357,000 by cutting out unnecessary testing.
The number may have been higher, but Vest explained to Information Week that certain injuries, such as a broken bone or superficial wound, may not necessitate further investigation. In fact, only 2.4 percent of all ER visits in the study saw a physician consult an HIE for more information.
"The level of [HIE] usage was not very high, but it was consistent with what other exchanges see," Vest told the website. "When it was used, it had a beneficial effect on utilization."
Vest hoped that the study would persuade medical professionals and government officials to push for wider use of the technology.
Predicting the future of HIE use
While physicians may be struggling to balance EHR implementation and preparation for the Oct. 1 ICD-10 transition, Vest's wishes may be prescient of a coming trend of wider HIE usage throughout the health care industry.
According to a recent MarketsandMarkets report, the global HIE market is expected to reach a value of $878 million by 2018. This new figure is nearly double the 2013 mark of $558 million. The report also indicated an annual growth rate of 9.5 percent, which would indicate steadily increasing implementation of the technology by health care professionals.