Research published this week in the journal Health Affairs suggests computerized patient records are unlikely to cut healthcare costs. The article says going paperless might actually encourage physicians to order costly tests on a more regular basis.
The study found that doctors using electronic health records to track patient tests, like X-rays or magnetic resonance imaging, order more tests than doctors using paper records.
The New York Times reported the study, noting that it was based on a survey conducted by the National Center for Health Statistics. They collected data from more than 28,000 patient visits to more than 1,100 doctors in 2008.
Commenters on the New York Times' Business Day site have been communicating much concern about not only the statistics entailed, but also the authenticity of the research.
"Cost savings will come AFTER we have integrated systems that exchange data versus pockets of EMR's," tweeted @JackShaffer. "The study is not looking at an integrated HIT system where lab tests from any provider are available to all others."
"Do doctors with e-records have better access to expensive tests?" asked @Citizen on the NYT site. "Did the e-records system suggest particular tests? Did the tests prove useful? I wonder if the study itself looked into these kinds of questions."
Commenter @Finkyp said that he assumed improvements in information technology wouldn't further drive up healthcare costs, yet he didn't believe that IT could make a dent in costs, given the large amount of tests, procedures, devices and medications. "Now it may become clear that the situation is actually even worse. Time to stop subsidizing this whole industry," he commented.
In agreement was @WendellMurray. "Electronic medical record systems in and of themselves do not reduce costs automatically," he stated. "They may in fact facilitate more utterly wasteful expenditure on the part of medical service provides, as the study indicates."
Doctors with electronic health records who had access to a patient's previous image results ordered tests for 18 percent of the visits, while those with paper records ordered tests on 12.9 percent of visits, according to the study.
"The problem is all healthcare providers are used to their current level of income and they will figure out ways to manipulate the system to maintain same income," commented @Wack. "Unless and until we pool in demand, reduce or eliminate unnecessary tests and pay based on outcome rather than treatment code, this hell will continue."
One way to look at it according to Twitter user @bradprince is that more exams equal a more accurate diagnosis. "Perhaps it is just better healthcare at the same cost overall," he tweeted.
@Kate suggests that digital records weren't ever supposed to cut costs necessarily, but allow for an aggregated view of a patient's health and well being by being able to share data between multiple sources.
"The real problem is interoperability. If my hospital is entirely on paper, then the data is useless to my primary care doctor, who still gets all my hospital records on paper," she noted.
Commenter @Srulik is a practicing physician who uses his electronic medical record on a daily basis. "I can say without hesitation that it has failed on multiple accounts," he shared on the New York Times site. "From this physician's point of view, the electronic medical record needs to be re-evaluated, reconfigured, re-booted, or just plain deleted."
Does going paperless really reduce the costs of healthcare? Tweet at us @HITNewsTweet and share your opinion!