Digital Records May Not Cut Health Care Costs?

I just ran across this article in the NY Times: Digital Records May Not Cut Health Care Costs

Computerized patient records are unlikely to cut health care costs and may actually encourage doctors to order expensive tests more often, a study published on Monday concludes.  Modern electronic health records are meant to give doctors an integrated view of a patient’s care, including medical history, treatments, medications and past tests.

Industry experts have said that electronic health records could generate huge savings — as much as $80 billion a year, according to a RAND Corporation estimate. The promise of cost savings has been a major justification for billions of dollars in federal spending to encourage doctors to embrace digital health records.

But research published Monday in the journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.

The use of costly image-taking tests has increased sharply in recent years. Many experts contend that electronic health records will help reduce unnecessary and duplicative tests by giving doctors more comprehensive and up-to-date information when making diagnoses.

The study showed, however, that doctors with computerized access to a patient’s previous image results ordered tests on 18 percent of the visits, while those without the tracking technology ordered tests on 12.9 percent of visits. That is a 40 percent higher rate of image testing by doctors using electronic technology instead of paper records.

I think another way to look at this is that healtlh care suffers from a generalized "failure to communicate," and IT's greatest contribution is to improve communication.  The EHR is one way to communicate, but not the only one, and casting everything in such a heavyweight issue with so much excess baggage blinds us to simpler, less expensive ways to improve health care.




Dr. Mostashari: "Recent Study: Get the Facts"

Jorge Cortell's picture

Interesting response to the aforementioned study in HealthITBuzz by Dr. Mostashari (link).



more responses

Tom Munnecke's picture

And here is the author's response:

I suspect we are going to be hearing more about this kind of stuff for a long, long, time.

It's also interesting to see the many parallels between VA and Kaiser emerging - including the fact that they use IT systems (VistA and Epic) that are architecturally first cousins, dating from the early MUMPS User's Group days: