Health Information Exchanges Said to Reduce Costs

The e-Health Inititiative, a multi-stakeholder nonprofit, just released results of its 2008 Health Information Exchange survey -- and says that HIEs save money. There are 42 exchanges in this year's survey, an increase of 10 since 2007.  The biggest challenge is said to be developing sustainable financing.

All of us know how much time and effort practicing clinicians spend tracking down imaging and laboratory results from other institutions -- and deeply believe that an information exchange is likely to save time and trouble and improve the overall quality of care.   But how compelling is the evidence that the system saves money?

This survey has some serious limits.  There is no standardized methodology to quantify cost savings or to allocate HIE costs.  I suspect that in many instances savings in medical costs might be fully offset by initial administrative costs of setting up and running these HIEs.  Further, the HIEs themselves are strongly biased toward reporting success rather than failure.   In many instances, costs are only eliminated when  previous non-electronic methods are eliminated.  For physician offices, for instance, there are no real resource savings until the staff that once tracked this type of material are laid off. 

I have no doubt that effective Health Information Exchanges should save money and improve the quality of care.  Whose money is saved is important - and calculating it right is critical if we're counting on those savings to make health care more affordable.