Though, from this data, it’s not clear through what mechanism.
This is an retrospective billing database evaluation of Memphis Emergency Department visits between 2007 and 2008. In Memphis, 12 EDs participate in an online data repository, which may be accessed by secure web connection. The authors compared patients presenting to the Emergency Department for whom this medical record was accessed to patients for whom this record was not.
There were no baseline differences between the demographics of the study groups, although, this retrospective evaluation cannot account for the factors contributing to why physicians chose to access the information exchange for individual patients.
The results are rather odd. The authors cite cost savings as a result of an OR of 0.27 for inpatient hospitalization after accessing the information exchange. However, the frequency of basically every other type of activity stayed flat or increased – in fact, the OR for Head CT was 5.0 and a chest x-ray was 4.3 if information exchange records were accessed.
More tests? Fewer admissions? I’m not sure it’s practical to generalize the effects of an information exchange on medical decision making in a retrospective fashion such as this.
“The financial impact of health information exchange on emergency department care.”
www.ncbi.nlm.nih.gov/pubmed/22058169