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Physicians Using Data Exchanges Order Fewer Lab Tests, Study Finds

Physicians who can access patients’ prior test results through a health  information exchange order fewer laboratory tests than doctors without such  access, according to a study published in the Archives of  Internal Medicine, Reuters reports.

Study Details

For the study, researchers examined care provided to 117,606 outpatients at  Brigham and Women’s Hospital and Massachusetts General Hospital between January  1, 1999 and December 31, 2004. The two hospitals established a health  information exchange in 2000.

Among the patients studied, 346 had received recent tests at the other  hospital and 44 of those patients had received the tests before the data  exchange was implemented.

Key Findings

In 1999 — before the data exchange was implemented — physicians ordered an  average of seven lab tests per patient, according to Alexander Turchin, one of  the study’s lead authors and an assistant professor at Harvard Medical School.  In 2004, that number decreased to four lab tests per patient, Turchin noted.

When researchers looked only at patients who did not have prior lab tests  available, they found that the amount of tests ordered increased slightly from  five tests per patient in 1999 to six tests per patient in 2004.

When researchers looked only at patients who had prior lab tests available,  the number of tests ordered decreased by about 49% after the implementation of  the exchange. After accounting for factors such as age and gender, the number of  tests ordered per patient with prior lab tests available decreased by about  53% after the exchange’s implementation.

Findings Appear To Conflict With Recent Study

The findings appear to conflict with a recent study published in the journal Health  Affairs (Seaman, Reuters, 3/29).

The Health Affairs study — by the Cambridge Health Alliance — found  that physicians with electronic access to patients’ previous imaging results  ordered tests 40% more frequently than their peers using paper-based records (iHealthBeat,  3/13).

Danny McCormick — author of the Health Affairs study — said the  results of the two studies could be different for several reasons, including the  fact that researchers looked at different populations.

Turchin noted that the two studies had different methodology and that his  study did not include imaging results like McCormick’s study (Reuters,  3/29).

Source: iHealthBeat

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