Research Activities, February 2014
Health information exchange reduces use of repeated diagnostic imaging for back pain
Health Information Technology
Health information exchanges (HIEs), which share electronic health information across health care organizations within a region, community, or hospital system, are advocated as essential to improving health care quality and reducing costs. For example, a new study found that use of an HIE reduced repeated diagnostic imaging for back pain. People with back pain who arrive at the emergency department (ED) often receive unnecessary imaging tests.
The study assessed how often ED personnel treating patients with low back pain checked HIEs for patients' imaging results and how that affected the frequency of re-imaging. It found that HIE use was associated with 64 percent lower odds of repeat diagnostic imaging. The decrease in overall diagnostic imaging was attributable to decreases in plain radiography. Magnetic resonance imaging was used only 2 percent of the time, both for visits with HIE use and those without. However, use of high-cost computed tomography of the spine was higher with health exchange use (2 percent) than without health exchange use (1.3 percent).
The end result was no cost savings. The HIE was accessed in 12.5 percent of 800 cases included in the study; 10 percent of these patients received additional imaging. In contrast, 24 percent of patients were reimaged when the HIE was not accessed. The patients included in the study were treated at 15 major hospitals and 2 regional clinics in the Memphis metropolitan area. This study was funded in part by AHRQ (Contract No. 290-04-0006).
For further details, see "Health information exchange reduces repeated diagnostic imaging for back pain," by James E. Bailey, M.D., Elizabeth C. Elliott, M.D., Jim Y. Wan, Ph.D., and others in the July 2013 Annals of Emergency Medicine 62(1), pp. 16-24.