- This week, the regional health information organization HEALTHeLINK welcomed its millionth patient participant.
Connecting 1,014 healthcare organizations and 4,600 physicians, the health information exchange (HIE) in western New York and has now obtained patient consent to exchange health data for the vast majority of Western New York residents. This marks a milestone for the 11-year-old HIE and presents providers with more opportunities than ever to cut costs and improve patient health outcomes.
Executive Director Daniel Porreca told Buffalo Business First that every patient with a complete health record in an HIE is playing an active role in optimizing their own care, noting “patients hold the key” to offering providers a complete view of their EHR.
“By consenting to allow your health care providers to access your medical information through HEALTHeLINK, you are giving them instant access to information that has proven to improve the quality of care, enhance safety, and reduce health care costs through the elimination of duplicate testing,” Porreca said.
Reducing unnecessary test ordering for as many patients as possible benefits both patients and providers. For example, a physician could refrain from ordering a new MRI if they have access to a patient’s EHR and see the patient recently received a scan. By avoiding an extra MRI, providers can keep from unnecessarily exposing a patient to radiation and save money by not ordering the test. In this way, eliminating redundancies in care delivery both improves patient health outcomes and cuts costs.
HEALTHeLINK is currently working to continue this positive trajectory by getting 100 percent of all Western New York providers and physicians to take part in the exchange and promote the benefits of participating in the exchange to their patients.
The HIE operates with government funding from the Statewide Health Information Network for New York (SHIN-NY) and the New York eHealth Collaborative, along with the financial support of local health payers and health systems in the region.
“They’ve continued to stay committed and focused on the success of our operation because they are more and more realizing the benefits,” Porreca added. “Really, these were visionaries: They saw the benefit before we were able to show the return.”
Promoting nationwide cost savings
Effective HIE use also benefits the healthcare industry on a national scale.
A study released earlier this month by researchers at the University of Notre Dame found nationwide HIE use could save Medicare more than $3 billion a year.
The study by Idris Adjerid, Julia Adler-Milstein, PhD, and Corey Angst showed healthcare markets with established, operational HIEs average savings of $139 per Medicare beneficiary a year.
However, incentives for payers and providers will need to be aligned and HIE capabilities must become more mature for the healthcare industry to achieve savings of this magnitude.
"Not all health care markets see the same amount of reduced spending from HIEs," said Adjerid. "We find that spending reductions are greater in health care markets where providers have financial incentives to use an HIE in ways that reduce spending. We also find that more mature HIEs—those that have been around longer—are more effective at reducing costs."
Research demonstrating the potential for HIE use to yield significant savings could drive more concerted efforts by policymakers to ensure provider incentives closely align with clinical improvements.
“Policymakers and health care entities need to ensure that financial incentives align with the goals of HIEs and give them sufficient time to mature before expecting promised value,” stated Adjerid.
Optimizing HIE use
Widespread HIE use and better-aligned incentive payment programs could establish the ideal breeding ground for industry-wide savings on both a large and small scale. However, providers can streamline care even further by optimizing HIE use with new technologies.
The Utah Health Information Network (UHIN) has demonstrated firsthand how incorporating new technologies into HIE use can improve care delivery and save hospitals money.
An editorial by UHIN President and CEO Teresa Rivera highlighted the value of adding admit, discharge, and transfer (ADT) notifications to HIEs. Rivera stated ADT notifications can improve care coordination and reduce hospital readmissions to avoid payment penalties.
“For those hospitals that post actual readmission rates greater than their predicted rates, the penalties can be stiff — as much as a 3 percent reduction in CMS payments for the new fiscal year,” wrote Rivera.
Connecting primary care physicians, care managers, and community hospitals that may have seen the patient previously or recently admitted the patient to share ADT information can help track a patient’s movement and progress across the care continuum.
“This secure and cost-effective method provides the patient’s entire medical team, regardless of where they work, with the important information they need to coordinate care,” wrote Rivera. “That coordination is important to reducing readmission rates, and helps health care professionals provide a better experience to patients.”
As HIE use matures, this level of care coordination could become increasingly commonplace and proliferate savings across care facilities and settings.