HIEs Don't Reduce Direct Healthcare Costs

The adoption of health information exchanges (HIEs) does not produce significant savings through reduction in imaging and lab order rates, according to a study published in the Journal of the American Medical Informatics Association.

Researchers from Colorado and Texas sought to determine the effects of the adoption of ambulatory HIE on the rates of laboratory and radiology testing, and allowable charges. HIEs, the effort to electronically share health information across organizations within a region or state, are growing across the country.

Using Design Claims data from the dominant health plan in Mesa County, Colo., from April 1, 2005 to December 31, 2010, the researchers matched the data to HIE adoption data on the provider level. Adoption of HIE was very limited across the country during that time period, but Mesa stakeholders formed the Quality Health Network HIE in 2005 and provider participation reached 46 percent by the end of 2010.

A total of 34,818 patients were analyzed from 358,000 laboratory and 127,500 radiology claims submitted by 306 providers in 69 practices. The researchers used mixed effects regression models with the quarter as the unit of analysis, the effect of HIE adoption on testing rates and associated charges was assessed. Researchers found that having access to the patient data from other providers via the HIE did not affect how lab and radiologist tests were ordered.

Although there was a drop in the number of lab tests ordered, researchers found, there was no significant drop in costs. There was no change in the number of usual and advanced radiology exams. There was also no significant change in number of exams or the costs between primary and specialty physicians.

The researchers concluded that adoption of ambulatory HIE was "unlikely to produce significant savings through reductions in rates of testing. The economic benefits of HIE may reside instead in other downstream outcomes of better informed, higher quality care."