It’s unclear whether electronic health records will reduce healthcare costs or improve care, according to a new paper in the journal, Health Affairs.

“Absent other fundamental interventions that alter medical practice, it is unlikely that the U.S. healthcare bill will decline as a result of the EHR alone,” writes Jaan Sidorov, MD, an associate in the department of general internal medicine at Geisinger Medical Center in Danville, Pa.

The paper, published in the July/August issue of Health Affairs, examined EHRs in ambulatory care.

The author argues that installation and maintenance expenses or EHRs will be passed to the consumer through higher bills. Without improvements in care quality or efficiency, “costs are likely to be accelerated,” he writes. He also writes that the literature on potential medical error reduction is unclear.

A study by the Rand Corp. found that national adoption of the EHRs could result in more than $81 billion in annual savings.

In an interview, Sidorov said that although EHRs can be useful in facilitating pay-for-performance programs and managing chronically ill patients, it’s just one tool among many that can be used to provide better care.

“The EHR is necessary to make that happen, but not sufficient,” said Sidorov, who practices in a paperless environment.

Some in the healthcare IT community agreed that technology alone is not the answer.

 “EMRs are not a silver bullet. They are a tool,” said Carla Smith, executive vice president of the Healthcare Information and Management Systems Society.

Michael Davis, executive vice president of HIMSS Analytics, the research arm of HIMSS, said that most EHR users have not installed some of the advanced functions that are expected to bring improvements in care and reduced costs.