It is important when there are hundreds of diagnostic tools that include medical service providers and patients to include costs and prevent unnecessary or duplicate testing.
The US health care expenditure has almost increased in recent years. $ 5 trillion One year, and part of this expenditure Unnecessary test.
Unnecessary tests are not always the result of excessive providers or worried patients. It can also be caused by sculptures and misunderstandings between suppliers and health care systems. Without connection ability, fragmentation can increase the risk of fragments. It makes health results disadvantageous.
The most common way to connect heterogeneous suppliers and health systems is to exchange health information, which is also called an electronic medical record interface. This platform allows you to deliver and view pre -testing, imaging and other medical meetings. But actually, does the provider actually actually tests a duplicate test for a veteran soldier?
Recent study
The evaluator of the partner’s evidence -based policy resource center started to answer the question in the following study. JMIR medical information. The author intended to estimate the effect of the JLV (JOINT LONGITUDINAL VIEWER) use on the overlapping imaging order of the Veterans Bureau (VA) and the Ministry of Defense (DOD).
JLV is a common electronic health system used by both VA and DOD, and suppliers of the two companies allow other companies to read -only access to patient health records. In this study, the author examined the data of the 2018 fiscal year and conducted a subsequent cross -sectional analysis.
The authors have seen 892 unique medical meetings related to the recently separated Veterans. As part of compensation and benefits screening tests, there were several exclusion criteria, such as a Veterans who visited the first medical treatment or cancer diagnosed with cancer.
In order to estimate the relationship between the use of JLV and the duplicate imaging during the first visitor, the author used the Logistics regression model. This model has been controlled for the last six months, including veteran age, gender and provider videos. In order to test the results of the robust model, the evaluator used the second stage general minimum square model and other specifications.
Results and limitations
Overall, the authors have shown that the use of JLVs by VA providers has increased since the 2015 fiscal year, when the system was first introduced. JLV’s monthly query has increased to more than 1.4 million by 2018.
The use of the system was related to the possibility of ordering duplicate imaging during the use of Peak JLV this year. VA providers who did not use JLV ordered 11.2%of duplicate imaging compared to 6.1%of JLV users’ time.
The evaluator also found a difference in the order of duplicate image between providers. historic JLV use and nothing. The VA first medical provider with a history of using JLV in six months before the study period was 5 % less likely to order duplicate imaging than the other party.
But the authors also acknowledged some of their limits.
First of all, they surveyed the first medical visit within 90 days of the video, so there is a possibility that redundant imaging still occurred outside the window or private treatment environment.
Second, the authors pointed out that the data source restrictions cannot be described between necessary or unnecessary duplicate tests. In short, the seemingly cloned video may actually be necessary to monitor the disease. The author has tried to alleviate this by excluding a veteran soldier with cancer, but the other state may need frequent tests.
Lastly, the authors pointed out that the results were lost by adjusting the definition of the supplier of the past JLV. According to the author, this suggested “heterogeneity of JLV benefits by frequency of use.”
Takeout
Research shows that using JLV and similar longitudinal health information exchange can reduce overlapping imaging, reducing patient burden and unnecessary expenditures. More research is needed to understand how electronic medical records can affect other tests and treatments in the future.
PEPREC is a team of health economists, public health researchers and policy analysts who support VA efforts to improve the lives of Veterans by using advanced quantum methods that are mostly funded by QUERI in the Veterans Health Bureau.
