Health Information Exchange Enhances Decision Making

The Wisconsin Health Information Exchange gives emergency room doctors access to patient data faster, helping improve clinical decisions and identify waste, drug abuse, and misuse of ER services.
Among recent individuals seeking care at Aurora Sinai was a patient who had visited emergency rooms in the region 38 times over the last year for ear problems.

The use of the exchange is helping Aurora Sinai find "medical homes" for such patients who are in need of a regular, long-term care by a primary care physician or other specialist, not frequent emergency room visits for non-emergency situations.

"Every ER visit costs $1,000," he said. The use of unnecessary emergency room care is not only wasteful, but it taps resources that can better allocated to patients who are true need of emergency services, he said.

Also, use of the exchange -- because it provides real-time data on all ER encounters a patient has -- helps ER doctors like Whitcomb identify patients who have drug abuse problems or are possibly illegally reselling narcotic drugs prescribed by ER doctors during the patient's many visits "for pain" to different emergency departments in the region, he said.

"The number one cause of death of teenagers is diverted drugs," he said. "This helps shed a light" on those problems, he said.

The ability to pull up electronic patient data at point-of-care allows Whitcomb to address patient issues and make clinical decisions more quickly "than waiting an hour for a paper chart to be pulled," he said.

Preliminary survey results based on responses from physicians at three sites using the WHIE found that there was a 42% reduction in time spent gathering data; workup or treatment of patient was altered 42% of the time; and the time to disposition decision decreased approximately 50% of the time, according to the WHIE.

To date, WHIE has received about $2.5 million in funding through several grants, said Pemble.

In addition, health insurer Humana -- which provides health benefits to many individuals employed by companies in Milwaukee County -- recently renewed a relationship with WHIE in which Humana pays a transaction fee whenever healthcare providers use the exchange to check member medical data at point of care, said Pemble.

To date, WHIE contains records for nearly 1 million patients and 4.15 million encounters. Approximately 50,000 real-time transactions take place daily on the exchange, according to WHIE.

As for Microsoft, its Amalga product is also being used in several other health information exchanges across the U.S., including in Washington D.C. and Hawaii, said Dr. Edward Barthell, director of Microsoft health solutions group.

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