- A recent study by Eftekhari et al. found connecting to a health information exchange (HIE) can help physician practices lower the amount of repeated therapeutic medical procedures administered to patients.
“Repetition of medical services by providers is one of the major sources of healthcare costs,” wrote researchers in the report. “The lack of access to previous medical information on a patient at the point of care often leads a physician to perform medical procedures that have already been done.”
Researchers in the study assessed four data sets including Medicare Provider Utilization and Payments data, Physicians Compare data, HIE enrollment data from members of HealtheLinkNY, and data from the US National Census database.
Researchers then merged the data sources into practice-specific and physician-specific sets to measure how HIEs affect healthcare providers in western New York.
In the first stage of the study, researchers used a predictive analytic model to estimate how long each practice has been involved with an HIE.
Researchers then used the data from this model for the second stage of the study, which predicted the effect of provider’s use of an HIE on the repetition of medical services they administer.
The study focused on 603 medical procedures and used medical experts to classify the procedures as either diagnostic or therapeutic. Medical experts labeled 122 procedures as diagnostic, 149 as therapeutic, and excluded 332 from inclusion in the study.
The model also incorporated the effects of federal quality assurance programs and complexity of procedure on repetitions of medical services.
Ultimately, researchers found while HIEs deter the repetition of therapeutic medical procedures, exchanges do not significantly affect diagnostic procedures.
“A major bulk of the medical data available in the HEALTHeLINK platform pertains to therapeutic procedures since they are pushed to the HIE by the large hospitals,” noted researchers.
In part, repetition of diagnostic procedures was less affected by a connection to an HIE because diagnostic procedures are simply less common than their counterpart.
“While diagnostics capture medical conditions at specific points of time, therapeutic data pertain to a continuum of care and hence are more frequent,” stated researchers. “Consequently, we do not expect HIE to significantly impact repetitions in the diagnostic cluster, while it could be significant in the therapeutic cluster.”
Researchers also determined federal incentive program variables change the impact of the HIE on repetition of medical services, while varying complexity does not.
“Further, we found evidence that impact of HIE on repetitions is more efficient for those who do not participate in PQRS program,” wrote researchers. “However, our results did not reveal that the level of complexity of medical procedures makes HIE impact stronger.”
The setting of the medical procedure also plays a role in whether the procedure is repeated.
“It is important and in the particular interest to health policy makers as the difference in the setting in which HIE is being used could lead to different outcomes,” stated researchers. “The medical encounters in physician offices are usually scheduled and thus non-urgent which makes the likelihood of repetition higher.”
In the discussion of the study, researchers stressed the significance of showing HIEs do not affect all medical procedures the same way.
Additionally, researchers urged policymakers to take note of the impact of different federal programs on physicians and medical procedures.
“Our findings inform health policy makers that concurrent participation of physicians in different initiative programs may impact the expected specific outcome of each program and thus subsequent healthcare outcomes,” wrote researchers.
This study of New York hospitals suggests strong HIE connections and federal incentive programs could likewise help deter costly, unnecessary medical procedure repetitions in healthcare organizations across the country.