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Health information exchange reduces repeated diagnostic imaging for back pain
James E Bailey1, Rebecca A Pope, Elizabeth C Elliott
1Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA. jeb@uthsc.edu
Annals of Emergency Medicine
|March 8, 2013
Summary
Health information exchange use significantly reduces repeated diagnostic imaging for emergency back pain evaluations. However, it did not lead to cost savings due to increased CT scans.
Area of Science:
- Health Informatics
- Emergency Medicine
- Radiology
Background:
- Repeated diagnostic imaging for back pain in emergency departments (EDs) contributes to healthcare costs.
- Health information exchange (HIE) aims to improve care coordination and reduce redundant procedures.
Purpose of the Study:
- To determine if HIE reduces repeated diagnostic imaging and associated costs in emergency back pain evaluations.
- To analyze the impact of HIE use on diagnostic imaging rates and costs in ED settings.
Main Methods:
- Longitudinal analysis of HIE patient-visit data for repeated ED back pain visits.
- Inclusion of visits with previous ED diagnostic imaging between 2007-2009 in Memphis.
- Primary independent variable: HIE use by ED personnel; outcomes: repeated imaging (radiograph, CT, MRI) and costs.
Main Results:
- 22.4% of qualifying visits had repeated diagnostic imaging.
- HIE use was low (12.5%) but associated with reduced repeated imaging (OR 0.36).
- No cost savings were observed due to increased CT imaging when HIE was used.
Conclusions:
- HIE use is linked to a 64% reduction in repeated diagnostic imaging for emergency back pain.
- The impact of HIE on estimated costs was negligible.
- Further research is needed to optimize HIE strategies for reducing unnecessary imaging and costs.
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