Access to Electronic Records Cause Doctors to Order More Tests

  on March 06 2012 2:00 PM
Electronic Medical Records
Allergy specialist Dr. Theodore Kim uses an electronic medical record system on a tablet notebook to manage medical records of patients at his practice in Chantilly, Virginia Contrary to popular belief, electronic medical records may increase healthcare costs, according to a new study. Reuters

Electronic medical records may not reduce health care costs as predicted, according to a new study.

The increased costs came from additional tests. Doctors who have access to electronic medical records and electronic methods of ordering tests ordered between 40 and 70 percent more X-rays, MRIs and other imaging tests than doctors who did not use electronic records, researchers found.

It's a somewhat surprising finding, Dr. Danny McCormick, study co-author and assistant professor of medicine at Harvard Medical School, told CNN. Health (information technology) is often put forward as a major solution to the cost crisis affecting the health care system. If it actually is not likely to decrease costs, we probably ought to know about that early on.

The Obama administration touted electronic medical records as a way to reduce health care costs.

A plan to modernize healthcare unveiled in 2009 provided $27 billion in incentives for doctors and hospitals to switch to electronic medical records, according to the Centers for Medicare and Medicaid Services (CMS).

Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy and save lives, President Obama told Congress in February 2009, according to CMS.

Switching to electronic medical records would reduce the number of duplicate tests, allow doctors to better track patient medications, reduce mistakes that come with paperwork and save $80 billion over the course of 15 years, according to the RAND Corporation, a nonprofit organization that performs research on behalf of government agencies, foundations and private businesses.

The medical researchers came to a different conclusion than RAND investigators.

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 authors wrote.

Electronic medical records make test ordering so easy that doctors might order the test again instead of looking at past results, according to the study.

Our research raises real concerns about whether health information technology is going to be the answer to reducing costs, McCormick told The New York Times.

But Michael Furukawa, a health economist in the Office of the National Coordinator for Health Information Technology, and the Obama administration's health information technology czar, criticized the study for being too narrow.

The data are sound, the methods are appropriate, but the focus is limited, he told The Washington Post. They only looked at one piece of health IT.

Furukawa told The Washington Post that more sophisticated electronic medical records warn doctors against ordering repeat tests.

Despite some issues, McCormick said electronic medical records are a great tool.

I'm a primary care doctor and I would never go back, he told The New York Times.

The journal Health Affairs published the study on Monday.

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