Providing access to health information technology and health information exchanges isn’t always enough to avoid ordering duplicative tests, according to the findings from a recent study
conducted by three major insurance carriers who represent approximately 65% of the commercially insured lives in Western New York—BlueCross BlueShield of Western New York, Independent Health, and Univera Healthcare.
The study analyzed data collected by the health information exchange HEALTHeLINK on the frequency of multiple computed tomography (CT) scans ordered for the same body part for the same patient over a six month timeframe. The insurers were trying to put a qualitative value on how many potentially unnecessary duplicative tests were being ordered by providers in Western New York, as well as potential cost savings to the health system.
The findings illustrate missed opportunities to both enhance patient safety and to reduce costs in the health systems, especially among providers who do not use HEALTHeLINK.
Among the highlights of the analysis:
During the 18-month study timeframe, 2763 CT scans were deemed to be potentially unnecessary duplicative tests.
Approximately 90% of the potentially unnecessary duplicative CT scans were ordered by physicians who either never or infrequently used HEALTHeLINK.
About 50% of the patients who had a duplicative CT scan had already consented to have their data accessed. Only 2.3% of the patients had denied consent.
More than 95% of the identified potentially unnecessary CT scans were done in a hospital setting.
The lost opportunity to use HEALTHeLINK before ordering a CT scan could have resulted in savings of approximately $1.3 million for the health system.
The study authors write that their findings demonstrate “a lost opportunity as well as the potential and value of health information technology and health information exchange for providing patients with the most effective and efficient course of treatment. As CT scans subject patients to a higher radiation dosage, reducing duplicative tests would also reduce one’s exposure to radiation.”
The report says that a substantial opportunity exists to help lower costs by eliminating unnecessary CT scans, which could have resulted in savings of more than $1.3 million to the Western New York health system. The findings suggest that if providers are enabled to use the health information exchanges and if patients provide physicians access through the consent process, then duplicate tests are far less likely to be done. In the long run, this saves time, money, and most importantly in the case of CT scans, eliminates unnecessary and potentially harmful radiation exposure to the patient.