IBJNews

Do electronic records really save money?

Back to TopCommentsE-mailPrintBookmark and Share

Uh oh.

Even though researchers at Indianapolis-based Regenstrief Institute Inc. demonstrated more than 20 years ago that electronic health records and test ordering systems significantly reduced costs in Indianapolis’ Wishard Health Services’ system, a recent study of electronic health records among office-based physicians came to the opposite conclusion.

The study, published in the journal Health Affairs, casts a bit of doubt on one of the main arguments for the rapid expansion of health information technology, which received a $30 billion boost from the 2009 stimulus act.

Having computerized health records made physicians 40 percent to 70 percent more likely to order imaging tests, according to the Health Affairs study, after the researchers adjusted for other kinds of differences among the 1,187 physicians and 28,741 patients visits analyzed in the study.

That flies counter to the conclusions of Regenstrief and Wishard researchers, which have found repeatedly that having electronic access to recent imaging test results eliminated duplicative testing, thus reducing costs.

In comments to the Wall Street Journal Health Blog, study author Danny McCormick said the Health Affairs study does not explain why office-based physicians using electronic medical records order imaging tests more frequently. But his team speculates that electronic medical record systems, by making it more convenient to receive imaging test results, may influence doctors to order them more frequently.

“If [doctors know] that the image result will show up on the screen with no questions and no problems, it may subtly influence them to order” the test, said McCormick, an assistant professor at Harvard Medical School.

The study authors note that their analysis says nothing about whether electronic health records can improve the quality of care—another argument frequently made in favor of their adoption.

“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,” the study authors wrote. “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.”

ADVERTISEMENT

  • Costs vs. revenues
    I suspect that the underlying difference in the results for Wishard Hospital as opposed to private physicians has less to do with electronic medical records, and more to do with the motivation behind their use.

    Wishard's compensation for service encourages frugal use of resources. Physicians on the other hand are still compensated primarily based upon the number of procedures completed.

    Market forces and the profit motive contribute to higher healthcare costs. Until the compensation and reimbursement system is based upon health outcomes, instead of the number of billable units performed, healthcare costs will continue to outpace the overall economy

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
 
Subscribe to IBJ
  1. President Obama has referred to the ACA as "Obamacare" any number of times; one thing it is not, if you don't qualify for a subsidy, is "affordable".

  2. One important correction, Indiana does not have an ag-gag law, it was soundly defeated, or at least changed. It was stripped of everything to do with undercover pictures and video on farms. There is NO WAY on earth that ag gag laws will survive a constitutional challenge. None. Period. Also, the reason they are trying to keep you out, isn't so we don't show the blatant abuse like slamming pigs heads into the ground, it's show we don't show you the legal stuf... the anal electroctions, the cutting off of genitals without anesthesia, the tail docking, the cutting off of beaks, the baby male chicks getting thrown alive into a grinder, the deplorable conditions, downed animals, animals sitting in their own excrement, the throat slitting, the bolt guns. It is all deplorable behavior that doesn't belong in a civilized society. The meat, dairy and egg industries are running scared right now, which is why they are trying to pass these ridiculous laws. What a losing battle.

  3. Eating there years ago the food was decent, nothing to write home about. Weird thing was Javier tried to pass off the story the way he ended up in Indy was he took a bus he thought was going to Minneapolis. This seems to be the same story from the founder of Acapulco Joe's. Stopped going as I never really did trust him after that or the quality of what being served.

  4. Indianapolis...the city of cricket, chains, crime and call centers!

  5. "In real life, a farmer wants his livestock as happy and health as possible. Such treatment give the best financial return." I have to disagree. What's in the farmer's best interest is to raise as many animals as possible as quickly as possible as cheaply as possible. There is a reason grass-fed beef is more expensive than corn-fed beef: it costs more to raise. Since consumers often want more food for lower prices, the incentive is for farmers to maximize their production while minimizing their costs. Obviously, having very sick or dead animals does not help the farmer, however, so there is a line somewhere. Where that line is drawn is the question.

ADVERTISEMENT