HIE Adoption Improves Patient Transfer Outcomes

A new study concludes that implementing health information exchange (HIE) protocols during inter-hospital transfers reduces diagnostic discordance and improves survival rates.

Researchers at the University of Minnesota (UMN; Minneapolis, USA) and Mayo Clinic Florida (Jacksonville, USA) conducted a study involving 180,337 adult patients transferred between 473 acute care hospitals in the states of New York, Vermont, Florida, Indiana, and Utah from 2011 to 2013. Diagnosis coding before and after hospital transfer was merged with data from the American Hospital Association (Washington, DC, USA; www.aha.org) to examine the frequency and impact of changes in diagnosis on patient risk, and whether HIE can improve patient safety by enhancing diagnostic accuracy.

The results revealed that discordance in diagnoses occurred in 85.5% of all patients; 73% of patients gained a new diagnosis following transfer, while 47% of patients lost a diagnosis. But while diagnostic discordance was associated with increased inpatient mortality, it also allowed for improved mortality prediction. The study also revealed that bilateral hospital HIE participation was associated with reduced diagnostic discordance index and decreased inpatient mortality. The study was published on May 29, 2018, in the Journal of General Internal Medicine.

“The more people that are involved in coordinating care, and the greater number of conversations that have to happen, the more potential there is for breakdowns in communication,” said lead author Michael Usher, MD, PhD, of the UMN division of general internal medicine. “The ability of two hospitals to talk to each other has the potential to improve patient safety, make care much more cost effective, and reduce mortality.”

HIE provides the capability to electronically move clinical information among different information systems, facilitating access to and retrieval of clinical data to provide a safer, more timely, efficient, effective, and equitable continuity of care, and reduced diagnostic tests and imaging. Other benefits include reduced expenses associated with manual printing, scanning, and faxing of documents; physical mailing of patient charts and records; and verification of delivery of referrals, records, and test results.

Related Links:
University of Minnesota
Mayo Clinic Florida