Healthcare // Clinical Information Systems
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3/13/2014
03:47 PM
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HIE Use In ER Cuts Hospital Admissions: Cornell Study

Emergency room patients whose doctors consult their records through a health information exchange were 30% less likely to be admitted, says a Cornell study.

Chart excerpted from the study.
Chart excerpted from the study.

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Alison_Diana
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Alison_Diana,
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3/14/2014 | 9:17:17 AM
Re: Why health records on exchanges hold down the cost of heatlh care
That's so true, Charlie. In addition to holding down costs, it's also better for patients to have fewer tests. Some of them expose us to radioactivity or other potentially harmful things. Plus who on earth wants to pay for things they don't need or get blood taken unnecessarily?!
Alison_Diana
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Alison_Diana,
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3/14/2014 | 9:14:56 AM
Re: Unused Asset
As you say in the story, in many ER cases it's obvious why a patient comes in: a broken bone, for example. I know, though, from speaking to healthcare professionals that every mouse click represents time -- and time is typically the enemy in healthcare, whether it's for the patient's health (as in an ER) or so doctors can see more patients (as in a family practice). Based on what you mention about Dr. Vent's comment re: integration, I'd imagine more integration would definitely increase use because ER staff would see all the necessary info within that one click. Whenever you add another click (and password sign-on), the number of users will decrease exponentially.

Most of us are huge privacy advocates, I'd guess, but when you're in the ER you're already concerned about your health or life and have passed along as much of your info as you know. Integrating HIEs with ERs seems a natural fit, one that doesn't threaten patient privacy. 
Charlie Babcock
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Charlie Babcock,
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3/13/2014 | 6:35:49 PM
Why health records on exchanges hold down the cost of heatlh care
The more conservative decision -- to admit for tests -- is all too often the one made, when doctors don't have enough information. Our litigious society where people go to court to assign blame if things go wrong ensures that this is so. If a doctor can access previous lab test and records of outcomes with a given patient, he or she has a stronger defense that he was making an informed decision, without an admission.
David F. Carr
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David F. Carr,
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3/13/2014 | 5:52:54 PM
Re: Unused Asset
There are some scenarios where HIE data can feed directly into the hospital EHR, but often the primary user interface is a separate web portal -- which makes checking whether there is any important info in the HIE repository a separate step. (I didn't get into it in the story, but there are also some HIEs that act as routing agents and don't maintain a central repository).

Given the complexity of clinical data integration, Dr. Vest said there are other levels of integration that would also help such as single sign on.
Alison_Diana
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Alison_Diana,
User Rank: Author
3/13/2014 | 5:23:10 PM
Unused Asset
The very small percent of ER doctors who use HIEs was really interesting and I'd like to learn more about why that is. I'd guess some regions have immature HIE implementations. Others haven't done much to market them to physicians. And in other cases some doctors may be unwilling to learn another electronic record. Is there a way to more easily and seamlessly integrate HIE records with multiple vendors' EHR records -- while simultaneously maintaining patient privacy so medical staff don't have unnecessary access to data when they don't need it?
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