Electronic Health Records = Fewer Unnecessary Tests

By Jane Farrell

Electronic health-records systems, in which medical information is securely shared, may be helping avoid unnecessary care, a new study shows.

Fewer emergency patients got repeated medical scans when they went to a hospital that takes part in a health information exchange, or HIE, according to researchers published online in the journal Medical Care.

Researchers from the University of Michigan said their findings are a good evaluation of the effectiveness of HIEs.

The researchers chose to examine emergency care, says senior author and U-M Medical School emergency physician Keith Kocher, M.D., because emergency department teams need information quickly in order to diagnose and treat a patient.

A physician’s ability to pull up a patient’s previous records from other hospitals is very promising, Kocher said. With an HIE, the physician has the ability to log in to a computer and pull up that patient's previous records from other hospitals instead of ordering duplicate tests or scans.

The findings show that the use of repeat CT scans, chest X-rays and ultrasound scans was significantly lower when patients had both their emergency visits at two unaffiliated hospitals that took part in an HIE. Patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get a duplicate ultrasound, and 67 percent less likely to have a repeated chest X-ray when both their emergency visits were at hospitals that shared information across an HIE.

The statistics were based on studies of California and Florida, who were early adoptees of HIEs

HIEs have been heavily pushed by the federal government, who offer states money to form them, and extra money to medical providers if they sign on. The exchange is part of the electronic health records system that hospitals and private practices are being incentivized to adopt.

In all, they found that patients in the two states underwent 20,139 repeat CT scans – meaning that 14.7 percent of those who had a CT scan in their first emergency visit had another one at their second emergency visit at another, unaffiliated hospital within a month.

There were also 13,060 repeat ultrasounds, which were ordered for 21 percent of those who had had ultrasounds at their first visit, and 29,703 repeat chest X-rays, ordered for 19.5 percent of those who had an X-ray at their first emergency visit.

The researchers etimated that if adopted nationwide, HIE might reduce health care costs by $19 million annually for these types of repeat imaging tests in the emergency room.