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Effects of health information exchange adoption on ambulatory testing rates. | LitMetric

AI Article Synopsis

  • The study aimed to evaluate how adopting electronic health information exchange (HIE) affects the rates of laboratory and radiology testing, as well as associated costs, using claims data from a Colorado health plan between 2005 and 2010.
  • It was found that while laboratory testing rates increased over time for both primary care and specialist providers, there was a significant downward shift in testing rates after HIE adoption, although costs did not decrease significantly.
  • The conclusion suggests that while HIE may not directly lower testing rates or costs, it could lead to improved care quality and better health outcomes which might offer economic benefits in other ways.

Article Abstract

Objective: To determine the effects of the adoption of ambulatory electronic health information exchange (HIE) on rates of laboratory and radiology testing and allowable charges.

Design: Claims data from the dominant health plan in Mesa County, Colorado, from 1 April 2005 to 31 December 2010 were matched to HIE adoption data on the provider level. Using 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.

Results: Claims submitted by 306 providers in 69 practices for 34 818 patients were analyzed. The rate of testing per provider was expressed as tests per 1000 patients per quarter. For primary care providers, the rate of laboratory testing increased over the time span (baseline 1041 tests/1000 patients/quarter, increasing by 13.9 each quarter) and shifted downward with HIE adoption (downward shift of 83, p<0.01). A similar effect was found for specialist providers (baseline 718 tests/1000 patients/quarter, increasing by 19.1 each quarter, with HIE adoption associated with a downward shift of 119, p<0.01). Even so, imputed charges for laboratory tests did not shift downward significantly in either provider group, possibly due to the skewed nature of these data. For radiology testing, HIE adoption was not associated with significant changes in rates or imputed charges in either provider group.

Conclusions: Ambulatory HIE adoption is unlikely to produce significant direct 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822119PMC
http://dx.doi.org/10.1136/amiajnl-2012-001608DOI Listing

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