Stunning Surprise: Going Electronic May Not Help Save Any Money in the Medical World

Just as we’ve been assured that electronic health records (EHRs) will make going to the doctor easier, safer and cheaper, now a new study points out that the availability of these digital records may also result in more medical tests for us, and higher costs, for everyone.

That’s right. No one – not us, not the doctors and not the health system itself – may save a dime. According to a story by Brian T. Horowitz, a Cambridge Health Alliance study found that doctors are now ordering more lab tests since they can view the images electronically. Possibly it’s because images are so easy to call up now, anywhere, anytime, but the study found that physicians who could get access electronically to patient histories tended to order additional tests 40-70 percent more of the time than those using paper records.

The report, called “Giving Office-Based Physicians Electronic Access To Patients' Prior Imaging And Lab Results Did Not Deter Ordering Of Tests,” concludes that, despite everything we’ve been led to believe, “using health care technology will not prevent doctors from ordering unnecessary lab tests,” according to Horowitz. The report was published in the March 2012 issue of the journal Health Affairs.

“We found no evidence that office-based physicians with electronic access to imaging or blood test results order fewer imaging tests or blood tests, respectively,” Horowitz writes that the report states. “Indeed, at least for imaging, the reverse may be true: Facilitating physicians' access to test results through computerization may increase diagnostic image ordering.”

But not everyone agrees, certainly not the person who should know the best, National Coordinator for Health IT Dr. Farzad Mostashari, who criticized part of the report.

“While such interpretations may make for attention-getting headlines, it's important to get the facts,” Dr. Mostashari wrote in a March 6 blog post, as reported in a story by Steve Lohr at The New York Times. “There are several reasons McCormick's study ultimately tells us little about the ability of electronic health records to reduce costs, and why it tells us nothing about the impact of EHRs on improving care.”

According to a story at healthcare informatics, in the past other studies have completely contradicted the report, estimating that “computerization in physician offices would save as much as $8.3 billion a year on imaging and lab testing.”

Even the lead author of the study was shocked. “It's a somewhat surprising finding,” Danny McCormick, a physician and assistant professor of medicine at Harvard Medical School, told CNN.com, Horowitz reported. “Health IT is often put forward as a major solution to the cost crisis affecting the health care system. If it actually is not likely to decrease costs, we probably ought to know about that early on.”

In The New York Times’ story, however, McCormick said he will still stick with EHRs despite the report's findings.

The study examined data from the National Center for Health Statistics' National Ambulatory Medical Care Survey, including 28,741 patient health records from visits to 1,187 doctors in 2008, according to eweek. (Interestingly, the research was done before the Obama administration's incentive program for “meaningful use” of EHRs began in 2009.)