Reducing HIE costs through real-time data feed visualizations.

Reliable and cost-effective health information exchanges require real-time monitoring of data sources, especially during implementation and deployment. MidSouth eHealth Alliance developers created a tool for real-time visualization of data feed logs which summarizes activity over multiple time windows and across different components, sources, and event types. This representation allows maintainers to differentiate between expected patterns and events that require rapid intervention to ensure reliable data handling, supporting efficient monitoring of and response to anomalous activity.

Mapping laboratory test codes to LOINC for a regional health information exchange.

Fully mapping laboratory tests to LOINC greatly increases functionality within a regional data exchange, but it is a costly process. As an inexpensive approach, we defined 53 "clinically significant" labs to map within the Memphis, Tennessee RHIO. These tests comprised a small percentage of unique test codes but a large percentage of laboratory message volume.

Predicting ambulance diversion in an adult Emergency Department using a Gaussian process.

When the Emergency Department (ED) reaches a critical level of overcrowding, it diverts ambulances to other hospitals. We evaluated the accuracy of a Gaussian process for prediction of ambulance diversion using March 1, 2005 November 30, 2005 data. The area under the receiver operating curve (AUC) for 120 minutes in advance was 0.

Estimated financial savings associated with health information exchange and ambulatory care referral.

Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of reducing these costs depends on the extent to which clinicians alter their workflow and take into account information available through the exchange from other institutions prior to initiating a treatment plan.

Computerized provider order entry in the emergency department: pilot evaluation of a return on investment analysis instrument.

The Vanderbilt Center for Better Health conducted a workflow analysis study to determine the benefits of implementing a computerized provider order entry system in the adult Emergency Department. Time savings by role was 1619 hours/year for nurses, 815 for medical receptionist, -95 for attendings, and -100 for residents. Translating time savings into bottom line savings (FTE/overtime reduction, additional charges) resulted in $31,424 in time savings and $40,000 cost savings (paper forms).