Related Experiment Video
Updated: May 4, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Does health information exchange reduce redundant imaging? Evidence from emergency departments
Eric J Lammers1, Julia Adler-Milstein, Keith E Kocher
1*Mathematica Policy Research †School of Information ‡School of Public Health, Health Management and Policy §Department of Emergency Medicine ∥Center for Healthcare Outcomes and Policy (CHOP), University of Michigan, Ann Arbor, MI.
Background:
Broad-based electronic health information exchange (HIE), in which patients' clinical data follow them between care delivery settings, is expected to produce large quality gains and cost savings. Although these benefits are assumed to result from reducing redundant care, there is limited supporting empirical evidence.
Objective:
To evaluate whether HIE adoption is associated with decreases in repeat imaging in emergency departments (EDs).
Data Source/Study Setting:
ED discharge data from the State Emergency Department Databases for California and Florida for 2007-2010 were merged with Health Information Management Systems Society data that report hospital HIE participation.
Methods:
Using regression with ED fixed effects and trends, we performed a retrospective analysis of the impact of HIE participation on repeat imaging, comparing 37 EDs that initiated HIE participation during the study period to 410 EDs that did not participate in HIE during the same period. Within 3 common types of imaging tests [computed tomography (CT), ultrasound, and chest x-ray), we defined a repeat image for a given patient as the same study in the same body region performed within 30 days at unaffiliated EDs.
Results:
In our sample there were 20,139 repeat CTs (representing 14.7% of those cases with CT in the index visit), 13,060 repeat ultrasounds (20.7% of ultrasound cases), and 29,703 repeat chest x-rays (19.5% of x-ray cases). HIE was associated with reduced probability of repeat ED imaging in all 3 modalities: -8.7 percentage points for CT [95% confidence interval (CI): -14.7, -2.7], -9.1 percentage points for ultrasound (95% CI: -17.2, -1.1), and -13.0 percentage points for chest x-ray (95% CI: -18.3, -7.7), reflecting reductions of 44%-67% relative to sample means.
Conclusions:
HIE was associated with reduced repeat imaging in EDs. This study is among the first to find empirical support for this anticipated benefit of HIE.
Related Concept Videos
01:30Methods of Documentation VII: EMR
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:24X-ray Imaging
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:30Radiological Investigation I: X-ray and CT