No HIE means 'lost opportunity' for cash

By Erin McCann
11:06 AM
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Utilizing lab ordering data from a health information exchange could signify millions of dollars in savings -- just from avoiding the scores of duplicate CT scans being ordered for patients.
 
How much money? Try $1.3 million, say the folks at HEALTHeLINK, the Western New York Clinical Information Exchange. And that's a conservative estimate. According to the findings of a new HEALTHeLINK study, there were 2,763 potentially unnecessary duplicate CT scans ordered by docs in Western New York. And the lion's share -- 90 percent -- of those providers either never or infrequently used HEALTHeLINK. 
 
Some 95 percent of these potentially unnecessary CT scans were done in a hospital setting, officials pointed out. 
 
 
Moreover, about half of the patients who had duplicate CT scans had already consented to have their data accessed through the HIE. 
 
David Scamurra, MD, pathologist at Eastern Great Lakes Pathology/X-Cell Labs and HEALTHeLINK chairman, was first to say these numbers make the case for joining an HIE. "These findings demonstrate the value an HIE provides by reducing the number of unnecessary tests, which saves time, money and radiation exposure to our patients," he said in a Feb. 17 news release. 
 
These findings not only signify potential from a financial perspective but also from a patient health perspective, officials say, considering one CT scan exposes the patient's body to about a year's worth of radiation, according to a report by Scientific American
 
Moreover, CT scans may result in up to 29,000 cases of cancer in the U.S., according to researchers at the National Cancer Institute. 
 
HEALTHeLINK analyzed 2011 and 2012 claims data provided by the region's three largest health insurers: BlueCross Blue Shield of Western New York, Independent Health and Univera Healthcare, all of whom are HIE stakeholders. 
 
Overall, more than 27,000 reports of duplicate CT scans within six months on the same body part were identified by officials, but after eliminating tests that were inconclusive, unknown, didn't match up or when the provider deliberately ordered a follow-up scan, the number came to 2,763.  
 
 
More than 70 percent of those providers who ordered unnecessary duplicate scans were HIE non-users, and 20 percent were reported as infrequent users. 
 
"We erred on being extremely conservative in our analysis, so we believe that the potential unnecessary radiation exposure to patients and cost savings to the health system could be significantly more," said Daniel E. Porreca, the HIE's executive director, in a press statement. "We believe this study shows that we are on the right track and renews our resolve to ensure doctors can efficiently and in a user friendly way use the information that is available to them in order to better treat their patients."