Emergency Departments: Click Before You Test
Emergency department (ED) physicians have to make quick life-or-death treatment decisions for patients they probably have never seen before. By necessity, they order tests to fill the information gap. If ED physicians could access their patients’ medical records, would all of those tests be necessary?
Click Before You Test
No, says Brookings Institution and fellow health information exchange (HIE) expert Niam Yaraghi. In a study published last year in the Journal of American Medical Informatics Association, Mr. Yaraghi measured the number of expected laboratory tests and radiology examinations ordered for two associated providers: ED patients whose records were accessed through an HIE and a control group whose records were not obtained. The result: HIE usage was associated with a 52% reduction in laboratory tests and 36% reduction in radiology examinations. “Why order a test when you can get results with a click?” asks Christina Galanis, President and CEO of HealthlinkNY, the HIE serving the Hudson Valley and Southern Tier of New York. “More ED clinicians need to regularly look-up patient records through HealthlinkNY because duplicating tests wastes time and money, and reduces a patient’s needless exposure to radiation and discomfort during a lab test.”
HIEs Offer Admissions and Discharge Records, Too
Besides test results, the HIE also presents a more complete picture of the patient. ED physicians need to know whether the patient has been hospitalized before, the patient’s medications, diagnoses, and history. All of this information can be looked up through the HIE, so clinicians don’t have to rely on the patient’s memory, particularly when patients are suffering and under stress. The HIE provides access to patient treatment records from other provider organizations—anywhere in New York State through the Statewide Patient Record Lookup (SPRL) feature—as long as providers are connected to the HIE and have obtained patient consent.Utilizing the HIE also adds efficiency to the intake process. Many ED patients may be too sick to fill out forms. It is far more efficient to print out a patient’s information (name, date of birth, allergies, medications, chronic conditions, and past hospitalizations, among other information) for the patient to review and approve.Ms. Galanis says, “To transition from fee-for-service to value-based payment models, and to improve patient experience, hospitals need to require HIE use in the ED. In addition, outpatient health care providers need to connect to the HIE to share and access data, too.”As Mr. Yaraghi said in an article about the Brookings Institution study, “Electronic exchange of medical data is one of the many different potential IT solutions for improving efficiency in the health care system; it facilitates the timely access to patients’ medical records, which is crucial for physicians to make better decisions and avoid many redundant and often harmful medical procedures. Fewer redundancies and better medical decisions will naturally lead to much needed savings in the health care system.”