Mostashari rankled over HIT survey conclusions

By Diana Manos
11:02 PM

At the HIT Policy Committee meeting on March 7, Farzad Mostashari, federal health IT czar, expressed strong disagreement over a new health IT survey published in the March issue of Health Affairs. The study has drawn a slough of national media attention.


he study touted that use of health IT is likely driving healthcare costs up. Mostashari said he was frustrated with the researchers’ “conclusion,” saying it was good for “grabbing headlines,” but not accurate.

[See also: e-Health records don't always equal reduced costs.]

The study was authored by Danny McCormick, assistant professor of medicine at Harvard Medical School; David Bor, chief of medicine at Cambridge Health Alliance; and Stephanie Woolhandler and David Himmelstein, both professors at CUNY School of Public Health.

The authors said they based the study on the analysis of 28,741 patient office visits to a nationally representative sample of 1,187 office-based physicians in 2008.

According to the authors, they found that doctors who have access to computerized imaging were 40 to 70 percent more likely to order additional tests. “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 claimed.

“We conclude that use of these health information technologies, whatever their other benefits, remains unproven as an effective cost-control strategy with respect to reducing the ordering of unnecessary tests,” they said.

[See also: EHRs are inevitable, experts say.]

“I want to set the record straight on what the study found and what the study actually did,” said Mostashari. “The study was not about EHRs, much less about the meaningful use of EHRs. It was about the electronic viewing of imaging results.”

He said the researchers failed to take into account the use of decision support and information exchange for reducing costs, available through the use of health IT. In addition, the data was from 2008. “And, as we know, a lot has changed,” he added.

The study also failed to analyze whether the additional testing that physicians ordered was appropriate, he said.

“When we talk about health IT reducing healthcare costs, it’s not going to come about by more or fewer lab tests. The big savings will come from improvements in the coordination of care,” Mostashari said. “Despite the power of anecdotes and headlines making an impact on our consciousness, we have to be careful to systematically review the evidence.”

“Health IT has the ability to give providers the tools and power to effectively reduce healthcare costs,” Mostashari insisted. “Yes, we are succeeding in making progress in health IT. That part is no longer in question.”

Mostashari’s remarks come as the Centers for Medicare & Medicaid Services prepares to release in a week its latest data – for February --on Stage 1 meaningful use of EHRs. As of January 2012, the government has paid out  $3.1 billion dollars in federal incentives for the meaningful use of electronic health records.

The abstract for the Health Affairs study can be found on the publication’s website, here. The abstract is available for free.

Follow Diana Manos on Twitter @DManos_IT_News.