About 25% of healthcare spending in the United States is unnecessary. That’s according to the Journal of the American Medical Association (JAMA).
JAMA’s 2019 study estimated the cost of waste in America’s healthcare system ranged from $760 billion to $935 billion.
The repetition of medical procedures contributes to this wasteful spending. Unfortunately, healthcare workers must have patients repeat tests when crucial data is too slow or missing.
Learn how disconnected data increases the cost of patient care, according to a nurse and a physician.
Redundant Tests
Sometimes, a medical worker can’t access a patient’s test results. Incompatible electronic health records (EHR) systems make data exchange difficult. In these situations, the health professional must perform a new study, or they can’t decide on treatment. But when there’s a second test, there’s a second charge.
“There’s an increased cost because we have to bill the insurance company for a test that was just done.” — RN, board-certified in cardiovascular nursing
Let’s say a nurse requests a patient to get a second blood test because the first blood test data is unavailable. Unfortunately, the patient must go through the process again. They may have to pay more even though the second test will likely produce similar results.
“It could be an out-of-pocket expense for the patient as well.” — RN, board-certified in cardiovascular nursing
With healthcare data integration, medical professionals can get test results from another organization no matter what systems they use.
“Interoperable EHRs will prevent the need to have duplicate tests because providers from a variety of locations can access a patient’s test results.” — Fact Sheet: Health IT Interoperability
Being able to share healthcare data sources eliminates redundant testing and extra expenses.
“Interoperable EHRs can streamline and reduce the cost of paperwork, tests,
and prescription orders to reduce the administrative process in providing healthcare.” — Fact Sheet: Health IT Interoperability
Extra Charges
Extra charges due to disconnected data go beyond the process of having the test done twice. The medical professional who analyzes the new results will also charge a fee.
“There are two fees. There’s the imaging and having somebody read it. So there again, that increases your cost.” — RN, board-certified in cardiovascular nursing
Let’s say a physician orders a second computerized tomography (CT) scan one week after the patient’s first test because they can’t find the information. Now there are two scan charges and two analysis fees.
Let’s say a physician can't find the results of a patient's computerized tomography (CT) scan. So they order a second test even though the patient had the first scan a week ago. Now there will be two scan charges and two analysis fees.
“Any imaging or procedures done are read by a cardiologist or a radiologist, and there's always an extra fee tagged onto that.” — RN, board-certified in cardiovascular nursing
With healthcare data integration, insurance companies and patients wouldn’t pay extra fees for duplicate tests with the same outcome.
“Connected data would keep costs down because labs wouldn’t be unnecessarily drawn again if the patient just had them in the last week or so.” — RN, board-certified in cardiovascular nursing
When EHRs are compatible, the patient only needs one test and one analysis.
“We don't need to do (a second test) and create an unnecessary charge. We already have that information.” — RN, board-certified in cardiovascular nursing
Patient Burdens
When a patient must repeat a test because medical staff can’t see the original data, they may deal with financial, physical, and time burdens.
“I had a patient who was in a car accident, and she had imaging done at an ER. I requested it a few months ago, and I haven't gotten any imaging reports. So I just ended up ordering more studies.” — MD, interventional pain physician
Let’s say, in this case, the insurance company only covers one test per year. This limitation means the patient will likely have to pay in full for the second set of images. The patient may also be suffering while waiting for treatment. Plus, it costs time to redo the study.
“You have to put in the order, have the patient find time on their schedule to go get the imaging done, and then come back.” — MD, interventional pain physician
With healthcare data integration, patients don’t worry about paying extra, prolonging pain, or wasting time because of unnecessary procedures.
“Electronic files allow information to be exchanged and used simultaneously and securely by
authorized users from multiple locations, which is conducive to better coordination of care.” — The Path to Interoperability
Compatible EHRs relieve patients from many hardships caused by disconnected data.
“When we achieve interoperability and widespread exchange of information, providers will have the infrastructure to deliver patient-centered, value-driven care that improves health outcomes while reducing costs.” — The Path to Interoperability
Interoperability Reduces Patient Care Costs
EHR interoperability provides more efficient data extraction in healthcare. Patient care costs decrease when medical providers can exchange information in real-time.
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