Use of Health Information Exchange and Repeat Imaging Costs

Hye Young Jung, Joshua Vest, Mark A. Unruh, Lisa M. Kern, Rainu Kaushal, Investigators HITEC Investigators

Research output: Contribution to journalArticle

15 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1364-1370
Number of pages7
JournalJournal of the American College of Radiology
Issue number12
StatePublished - Dec 1 2015
Externally publishedYes


  • electronic health records
  • health care costs
  • health information exchange
  • Radiology
  • utilization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Jung, H. Y., Vest, J., Unruh, M. A., Kern, L. M., Kaushal, R., & HITEC Investigators, I. (2015). Use of Health Information Exchange and Repeat Imaging Costs. Journal of the American College of Radiology, 12(12), 1364-1370.