Vanderbilt U: $2 million just the beginning of HIE savings
Emergency departments in the Memphis, Tenn., area realized an annual cost savings of nearly $2 million as a result of sharing electronic health information through the MidSouth eHealth Alliance, according to a Vanderbilt University study that was recently published in the Journal of the American Medical Informatics Association.
"The evaluation study was the product of a six-year effort to create a sustainable health information exchange among every major hospital in Memphis, Tenn.," said Mark Frisse, MD, professor of biomedical informatics at Vanderbilt, and lead researcher.
"The primary goal of this effort was to assure that medical information could be transmitted securely and with patient consent among all hospitals when patients sought care," he said. "Our rigorous study shows that net of operating costs, even limited voluntary access to data obtained through HIE confers societal savings - primarily through reduced hospital admissions."
The Agency for Healthcare Research and Quality (AHRQ) and the State of Tennessee funded the study entitled The Financial Impact of Health Information Exchange on Emergency Department Care. "This study involves all hospital data from any consenting patient - not just ED data," Frisse pointed out. Research started in the EDs at the behest of the Memphis leadership, who determined that the ED environment was the best "common ground" to demonstrate value and to foster trust in HIEs.
The nonprofit MidSouth eHealth Alliance, which was formed in 2004 through grants from AHRQ and the State of Tennessee to govern and manage HIE services, enables 16 hospital EDs and ambulatory clinics in the Memphis metro area to share patient information. Vanderbilt University Medical Center developed the technologies that were deployed to provide the HIE services, and the university formed a team to manage operations.
HIE capability in the ED was available beginning in May 2006 and phased in over the study period. Collection of HIE use data began once all the major hospital EDs had access to HIE. Clinicians were later able to access patient information from hospital wards and in ambulatory clinics.
According to the study, as of October 1, 2010, more than 7.5 million encounter records on 1.7 million patients, 4.9 million chief complaints, 45 million lab tests, 5 million radiology reports and 2.1 million other reports and documents were accessible to clinicians. While the amount and type of data varied, clinical information was available for nearly every patient whose information was accessed through the web-based HIE interface. Patients were allowed to opt out of participation in the HIE when they presented at participating hospitals and clinics. The opt-out percentage ranged from 1 percent to 3 percent across all sites over the study period.
MidSouth eHealth alliance has been operated and financed by a local governing board and a freestanding HIE service provider since October 2010. Vanderbilt no longer is involved and the effort is now self-sustaining, Frisse said. "We believe that far more substantive savings will be realized as clinical health information is securely exchanged across care transitions and among ambulatory settings and other care sites," he said.