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Cited by 60Electronic Health Records SystemsHealthcare cost, quality, practicesRadiology practices and education

Use of Health Information Exchange and Repeat Imaging Costs

Open access
Jung, Hye-Young, Vest, Joshua R., Unruh, Mark A., Kern, Lisa M., Kaushal, Rainu·2015·Journal of the American College of Radiology
DOI 10.1016/j.jacr.2015.09.010PMC PMC4722040
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Abstract

Purpose 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.

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  • Studies have found that HIEs make patient information more available and accessible across organizations and have reduced duplicate testing and imaging and diagnostic discrepancies, lowered costs, and improved patient safety.

    “Studies have found that HIEs make patient information more available and accessible across organizations and have reduced duplicate testing and imaging and diagnostic discrepancies, lowered costs, and improved patient safety [5–8].”

    From Evolution of clinical Health Information Exchanges to population health resources: a case study of the Indiana network for patient care (2025) · cites this paper as [7]

    The HIE Intervention section describes access to patient information contributed by multiple organizations. The Results report an association between HIE access and less repeat imaging, with estimated imaging cost savings. The paper does not establish reductions in duplicate testing generally or diagnostic discrepancies, nor does it report improved patient safety; the sentence also states the imaging and cost findings more causally than the paper does. (LLM, conf=0.88)

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  • Maintaining and advancing HIE infrastructure and engagement, and aligning policy with those efforts, remains necessary for expanding the reach and impact of community HIEs.

    “Maintaining and advancing HIE infrastructure and engagement, and aligning policy with those efforts, remains necessary for expanding the reach and impact of community HIEs [4, 7, 8, 46].”

    From Evolution of clinical Health Information Exchanges to population health resources: a case study of the Indiana network for patient care (2025) · cites this paper as [7]

    The Discussion (page unavailable) supports investment in HIE and says further study is warranted as HIE becomes more widely implemented and providers gain experience. It does not establish that continued infrastructure development, engagement, and policy alignment are necessary to expand community HIEs’ reach and impact; that wording turns a tentative possibility into a requirement. (LLM, conf=0.82)

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Research works printed but not linked: 36

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Authors
Jung, H.-Y., Vest, J. R., Unruh, M. A., Kern, L. M., & Kaushal, R.
Affiliations
  • Weill Cornell Medicine (US)
  • NewYork–Presbyterian Hospital (US)
Corresponding author
Jung, Hye-Young
ORCID
Venue
Journal of the American College of Radiology
Publisher
Elsevier BV
Published
2015-12
Volume
12
Issue
12
Pages
1364-1370
ISSN
1546-1440 (ISSN-L)
DOI
10.1016/j.jacr.2015.09.010
PMC
PMC4722040
OpenAlex
W2180097104
Cited by
60
References
0
Citations by year
2026: 2 · 2025: 5 · 2024: 11 · 2023: 7 · 2022: 5 · 2021: 7 · 2020: 8 · 2019: 2 · 2018: 5 · 2017: 6 · 2016: 1 · 2015: 1
FWCI
7.87
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American College of Radiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (T32AG023482)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Keywords
health information exchange, repeat imaging, imaging costs, cost reduction, advanced imaging, radiography, ultrasound, mammography, computed tomography, magnetic resonance imaging, commercial health plans, health information technology
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Diagnostic Imaging, Female, Humans, Male, Middle Aged, New York, Patient Acceptance of Health Care, United States, Utilization Review, Cohort Studies, Cost Savings, Young Adult, Health Information Exchange

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