Are Electronic Health Records the Solution? Doesn’t Seem Like it

Electronic health records (EHR) streamline physician and patient interactions, and they’re the easiest way to access a patient’s medical history, medications, and radiology images. The original initiative behind EHRs was to create more efficient medical care, and ultimately reduce costs. Yet, a recent study from Stanford University and the National Bureau of Economic Research demonstrate that doctors who find themselves regularly using EHR also request more complete blood tests (CBCs), CT scans, and x-rays than physicians who don’t use the system. These services rack up expenses that can be considered repetitious or unnecessary.

Upon surveying 183,519 “patient-provider engagements”, researchers discovered that physicians who relied on EHR were 30 percent more likely to order CBCs, 41 percent were more inclined to order CT scans, 37 percent were more likely to order x-rays, and 23 percent were more likely to request other kinds of imaging tests. The researchers only focused on primary care practitioners, and did not evaluate radiologists, pathologists, or anesthesiologists.

Although researchers only used data from 2008 and 2011, they found that the highest rates of test ordering occurred in large practices where physicians have little influence over computer systems. They also discovered that demographics and insurance type didn’t influence the physicians’ decision to order tests.  

“Implementing EHR systems may become cost-effective only when complemented by models of care that emphasize quality, value, and efficiency,” wrote the researchers. “Against a backdrop of policies suggesting cost savings for EHR use, these results call for a reassessment of the unqualified expectation that EHRs will reduce medical expenditures and increase clinical efficiency.”