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Electronic Medical Records May Not Cut Health Costs

Although experts have long argued that computerized patient records will save the healthcare system money by helping healthcare providers reduce the number of redundant or inappropriate tests they order, a new study disputes that.

The study found that office-based healthcare providers who have access to electronic records of patient care are actually more likely to order additional imaging and laboratory tests than healthcare providers who rely on paper records. The study was based on a 2008 survey by the National Center for Health Statistics that collected data from 28,000 patient visits to 1,100 healthcare providers. It found that healthcare providers who could call up electronic images of a patient’s previous imaging tests—such as x-rays and computed tomography (CT) scans—ordered new imaging tests in 18% of the visits, whereas healthcare providers without such access ordered imagining on only 12.9% of the visits (a 40% increase). The increase was 70% higher for the most advanced and expensive images, such as magnetic resonance imaging and CT scans. Although the study did not explore why there was an increase, the researchers suggested that the ease of ordering tests and receiving results by computer may encourage healthcare providers to order more tests then they would have if they had to get results by telephone and interpret faxed images.

Although many other studies support the use of computerized medical records, this study raises a cautionary note about whether health information technology is the answer to reducing costs. The researchers concluded that the use of health information technologies, whatever their other benefits, remains unproven as an effective cost-control strategy with respect to reducing the ordering of unnecessary tests.

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