Health information exchanges improve provider efficiencies and save health plan costs

A new study conducted by Humana (NYSE: HUM) and the Wisconsin Health Information Exchange (WHIE) found that health information exchanges (HIE), when used in emergency departments, resulted in improved provider efficiencies and health plan cost savings. The peer-reviewed analysis, which is the first to closely examine the benefits accrued by health plans that support health information exchanges, is published in the July/August issue of American Health & Drug Benefits.

“While historically it has been difficult to measure the economic value of health information exchange, this research further demonstrates that HIEs provide substantial value for health plans, in addition to value realized by providers and patients”

The study, which ran from December 2008 through March 2010, evaluated the effectiveness of community-based HIEs - the secure transfer of health care-related data among facilities, health information organizations and government agencies, for patients seeking care in emergency departments. The analysis examined 1,482 fully insured Humana members in Southeast Wisconsin who sought care at emergency departments at 10 Milwaukee hospitals. Clinicians in the emergency department could query the HIE to view patients' historical medical encounter information to help them make diagnosis and treatment decisions.

"Emergency department utilization continues to increase across the country, with inefficiencies such as duplicative testing and lack of medical history contributing to increased costs and creating a burden on the entire health care system," said Dr. Albert Tzeel, study author and National Medical Director, HumanaOne. "By allowing clinicians to have access to patients' medical history at the point of care in the emergency department, we found significant cost reductions and a decrease in redundant diagnostic testing. This proves that HIEs not only provide a value for the health plan, but also improve care coordination and help control costs for patients."

The research found definitive decreases in four of the top five emergency department-based procedures, including CT scans, EKGs, laboratory testing and diagnostic radiology, when the patient database was queried by clinicians. These decreases resulted in an average savings of $29 per emergency department visit due, in large part, to the reduction of test redundancy, which helped mitigate waste and control costs. Prior research has shown that even cost reductions of $10 per emergency department visit could yield substantial savings for health plans.

"While historically it has been difficult to measure the economic value of health information exchange, this research further demonstrates that HIEs provide substantial value for health plans, in addition to value realized by providers and patients," said Kim Pemble, executive director of the Wisconsin Health Information Exchange. "Hopefully, HIE initiatives will see a rise in the adoption and support of this technology by health plans as a result of the increasing validation of its numerous benefits, including cost savings, patient safety and improved care coordination."

Health information exchange is an integral component of the nation's health information technology infrastructure and is crucial to meeting meaningful use requirements, which mandates that electronic health record (EHR) systems exchange health information electronically among health organizations.

"We believe this study from Humana represents a truly important step toward improving the quality of care and reducing health care costs," said Nicholas Englezos, publisher, American Health & Drug Benefits. "This is a further step toward achieving greater value in health care, which reflects the editorial mission of this journal."

Source Humana and Wisconsin Health Information Exchange