Study: HIEs Can Help Significantly Reduce Unnecessary ED Tests

July 23, 2015 in News

Leveraging data from health information exchanges can significantly reduce unnecessary emergency department tests, according to a study published in the Journal of the American Medical Informatics Association, Modern Healthcare reports.

Study Details

The study was conducted by the Brookings Institution and supported by HEALTHeLINK, a Buffalo, N.Y.-based HIE.

For the study, researchers assessed more than 2,000 ED visits in three western New York hospitals between March 2014 and May 2014 (Conn, Modern Healthcare, 7/22).  

During a six- to eight-week period, clinical liaisons from HEALTHeLINK shadowed ED doctors at:

  • Buffalo General Medical Center;
  • Erie County Medical Center; and
  • Kenmore Mercy Hospital.

During this period, 1,450 patients were seen (Leventhal, Healthcare Informatics, 7/22).

For the study, ED patients were divided into two groups. One group of 737 patients had physicians who used HEALTHeLINK’s data to find relevant clinical information, while the other group of 1,275 patients were treated by physicians who did not use the HIE data (Modern Healthcare, 7/22). 

For the first group, the clinical liaisons retrieved any potential clinically relevant data such as patients’:

  • Hospital admissions;
  • Discharge transcripts;
  • Laboratory results;
  • Medication history;
  • Operative reports; and
  • Radiology examinations (Healthcare Informatics, 7/22).

Study Findings

Researchers found that using HIE data at the first hospital ED led to a 52% reduction in lab tests and a 36% reduction in radiology exams.

At the second ED, the HIE data led to a 25% decrease in lab tests and 26% decrease in radiology exams.

Meanwhile, the third ED saw a 47% reduction in radiology after leveraging HIE data. The HIE did not have an effect on the number of lab tests ordered at the third hospital because patients were seen for cardiovascular and neurovascular issues that required new lab tests regardless of previous results (Drury, Buffalo Business First, 7/22).

According to Modern Healthcare, the study also found using scribes proved more efficient for doctors when searching for patient information.


Niam Yaraghi, a fellow at the Brookings Institution and the study’s principal researcher, noted that the use of clinical liaisons, or scribes, made it easier for doctors to find patient information.

He said, “The mere existence of them point to the user unfriendliness of our EHR systems.” Yaraghi added, “If we had asked the doctors to do it themselves, they wouldn’t do it. The HIE access rate is about 6% to 7% of the patient encounters. Physicians don’t have the time to do it” (Modern Healthcare, 7/22).

Dan Porreca, executive director of HEALTHeLINK, in a statement said, “This study highlights just one component of the value of interoperability and doctors’ access to their patients’ data that HEALTHeLINK and health information technology can provide in improving the quality and efficiency of patient care and enhancing patient safety.” He added, “While direct and indirect costs of these tests can vary by hospital and region, physicians ordering fewer tests because recent pertinent clinical information is available through HEALTHeLINK directly leads to overall costs savings for our local health care community” (Healthcare Informatics, 7/22).

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