Good, widely used EHR systems should reduce administrative costs, help physicians and hospitals do a better job of coordinating care, and reduce the likelihood that providers will duplicate tests patients have already had.
Some naysayers have argued that EHR systems might not be all they’re cracked up to be, pointing out that many EHR promoters, such as large consulting firms, have a financial incentive to hype EHR technology; that many countries with far more efficient health care systems are just starting to use EHR technology; and that converting existing paper patient files into electronic form will be expensive and time-consuming.
Now Danny McCormick, a medical professor at Harvard University, and three colleagues are raising another point: EHR systems might not actually do much to discourage physicians’ tendency to order duplicative tests.
McCormick and his colleages have published a paper on that topic in the latest issue of Health Affairs, a health finance and delivery journal.
The researchers tested the idea that health information technology access could reduce ordering of duplicate tests by analyzing records of 28,741 2008 patient visits to 1,187 office-based physicians.
The researchers also looked at whether physicians had had electronic access to test results.
The researchers found that doctors with electronic test record access were 40% to 70% more likely to order additional blood tests than other physicians were.
“The availability of an electronic health record in itself had no apparent impact on ordering; the electronic access to test results appears to have been the key,” the researchers say in a study abstract. “These findings raise the possibility that, as currently implemented, electronic access does not decrease test ordering in the office setting and may even increase it, possibly because of system features that are enticements to ordering.”
SMALL IS BEAUTIFUL
Some employers and health plans have been trying to hold down health care prices in the past few years by returning to plans featuring fewer providers.
Plans are hoping they can negotiate better rates for better quality care by funneling more patients to a relatively small number of highly efficient doctors and hospitals.