Why electronic medical records may not save money

A recent study from Health Affairs has been generating some buzz, as well as passionate rebuttals.

According to the study, doctors who used electronic medical records actually ordered more tests, compared to those who used paper records.

There was a 40% increase in ordering imaging tests, a number that increased to a whopping 70% when it came to advanced tests, like MRIs or CT scans.

According the the study’s lead author, “Our research raises real concerns about whether health information technology is going to be the answer to reducing costs.”

The findings have generated controversy, with critics pointing to flawed methods and old data.

Despite who’s right, whether electronic medical records truly save money is seriously in question.

The study didn’t offer any reasons why doctors ordered more tests, but speculated it was because it was simply easier. What used to take pen and paper to order now takes a mouse click or two.

The findings don’t surprise me. Aside from large integrated systems, like Kaiser Permanente in California and the Veteran’s Administration, most physician practices adopt different EMRs. And in many cases they don’t talk to one another. So, a physician’s record may not able to able to access notes from his local hospital if they used different systems. Some doctors in that situation may simply re-order a test, rather than go through the time of obtaining the records from the hospital.

The true power of digital records come when using a single, unified system that can be accessed by different health venues. With the exception of large integrated health systems, we have mostly have a mess of siloed, fragmented EMRs.

Perhaps with the consolidation health reform is instigating, more doctors will be able to practice under a unified EMR, which then would realize more cost savings. But until that happens, EMR evangelists who promise lower costs may find their expectations cut drastically short. The technology simply isn’t there yet.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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