Regional and statewide health information exchanges (HIEs) have become increasingly capable platforms for facilitating the secure exchange of clinical documents, making health records accessible when and where needed in an ongoing quest to enable more informed care decisions. In fact, 92% of the U.S. population is served by America’s HIEs who are members of the Strategic Health Information Exchange Collaborative (SHIEC), according to a study released by the organization.
However, notable gaps persist. For example, we estimate that no more than 10% of HIEs include diagnostic medical image sharing, yet medical imaging is one of the most critical tools for making clinically informed care decisions related to some of the most pernicious diseases known to mankind.
Medical imaging is also one of the more expensive components of patient care. The American College of Radiology (ACR) reported that diagnostic imaging accounts for 10% of total annual health care costs. That equates to an astonishing 2% of GDP, or $1,000 for every American each year. Researchers at the Brigham and Women’s Hospital in Boston, MA estimated that nearly 9% of imaging is unnecessary or redundant. Other studies have produced even more impactful results. Researchers in New York State concluded that HIE system access of images and imaging results reduced the odds of a repeat imaging exam by 25%.
Why do many leading health care institutions resist sharing vital medical imaging with care providers across the community? And conversely, why have health care organizations in some parts of the country been so successful?
eHealth Technologies has worked with HIEs to onboard medical image sharing across a number of state, regional, and local HIEs, connecting over 200 hospitals and imaging centers to their affiliated HIE. Since we began almost 13 years ago, we have experienced a familiar pattern. Building an interoperable medical image sharing network is like starting up a freight train. It requires a tremendous amount of energy and time to build momentum. Invariably, there are a vital few anchor institutions and health systems that hold the key to success. While a significant proportion of every day care is delivered by the critical many—small, local physician clinics and hospitals where medical images are frequently needed—typically, support from anchor institutions is needed to unlock an entire community’s access to patient images.
Time and time again, once these vital few open up access to their medical images for the outside community by way of their HIE, the critical many smaller players quickly follow, as the benefits from improved patient care and reduced operating costs are realized.
Interestingly, once the smaller institutions follow suit in sharing images through their HIE, even more benefits flow back to the larger, earlier adopters as the burden of meeting the daily requests for sharing images with numerous care providers all but disappears. They are no longer required to respond to each and every external request by searching their PACS for images, burning and shipping CDs, or manually pushing images to a cloud-based service. Image sharing and exchange, in its most elegant and automated form, is handled almost entirely by way of the HIE. Only HIEs can enable seamless, automated access to a patient’s full medical imaging history, across an entire region, state, and eventually country. This is because only HIEs have the mechanisms needed to truly streamline workflow such as the ability to reconcile patient identities across institutions, authenticate users, and assure patient consent is enforced.
In summary, the vital few health care institutions in most communities hold the key to whether medical image exchange becomes a reality or remains a pipedream. Our hope is that in the end these vital few will do what is right for their patients and their community.
Lead the way!
