title: Use of Health Information Exchange and Repeat Imaging Costs.
abstract: OBJECTIVE
  The aim of this study was to quantify the association between health information exchange (HIE) use and cost savings attributable to repeat imaging.
  
  
  METHODS
  Imaging procedures associated with HIE were compared with concurrent controls on the basis of propensity score matching over the period from 2009 to 2010 in a longitudinal cohort study. The study sample (n = 12,620) included patients ages 18 years and older enrolled in the two largest commercial health plans in a 13-county region of western New York State served by the Rochester Regional Health Information Organization. The primary outcome was a continuous measure of costs associated with repeat imaging. The determinant of interest, HIE use, was defined as system access after the initial imaging procedure and before repeat imaging.
  
  
  RESULTS
  HIE use was associated with an overall estimated annual savings of $32,460 in avoided repeat imaging, or $2.57 per patient. Basic imaging (radiography, ultrasound, and mammography) accounted for 85% of the estimated avoided cases of repeat imaging. Advanced imaging (CT and MRI) accounted for 13% of avoided procedures but constituted half of the estimated savings (50%).
  
  
  CONCLUSIONS
  HIE systems may reduce costs associated with repeat imaging. Although inexpensive imaging procedures constituted the largest proportion of avoided repeat imaging in our study, most of the estimated cost savings were due to small reductions in repeated advanced imaging procedures. HIE systems will need to be leveraged in ways that facilitate greater reductions in advanced imaging to achieve appreciable cost savings.
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York; Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York. Electronic address: arj2005@med.cornell.edu.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York; Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York; Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Unruh
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York; Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.affiliation: Center for Healthcare Informatics & Policy, Weill Cornell Medical College, New York, New York; Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York; New York-Presbyterian Hospital, New York, New York.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017046:Cost Savings / Q000191:economics* / Q000706:statistics & numerical data*; D003952:Diagnostic Imaging / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D066275:Health Information Exchange / Q000191:economics* / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review; D055815:Young Adult
keywords: Radiology; electronic health records; health care costs; health information exchange; utilization