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A recent study from Harvard Medical School and CUNY School of Public Health is stoking tensions in the debate about whether EHRs are as cost effective as they are portrayed by proponents of the technology. The conclusions of the new report suggest that the use of Electronic Health Records may do little to cut the high cost of delivering medicine. In fact, the report suggests that EHRs may actually encourage doctors to prescribe more tests, resulting in higher costs.
Danny McCormick, a physician and assistant professor of medicine at Harvard Medical School and lead author of the report said that “our findings should at a minimum raise questions about the whole idea that computerization decreases test ordering and therefore costs in the real world of outpatient practice. As with many other things, if you make things easier to do, people will do them more often… Our research raises real concerns about whether health information technology is going to be the answer to reducing costs… The federal government’s ongoing, multibillion-dollar effort to promote the adoption of health information technology may not yield anticipated cost savings from reductions in duplicative diagnostic testing. Indeed, it is possible that computerization will drive costs in this area up, not down.
The results of the new study though were refuted by proponents of EHRs. Dr. David Blumenthal, former Harvard professor and national coordinator for health information technology at the Department of Health and Human Services for the Obama administration from 2009-2011, told the PBS news hour that “This is one of many, many studies, and the studies are overwhelmingly supportive of cost-reductions by using electronic health records. Anytime you see anything that is complicated like this (the implementation of EHR throughout the system), some studies will be positive, some will be negative. But if you look at the total review of literature that was done a year ago, it puts it into context: 92 percent of studies were positive. I expect that if you study something 100 times, there’s going to be some variation.”
Farzad Mostashari, MD and National Coordinator for Health Information Technology, blasted the study by McCormick, found numerous faults with the study, one of which is that “ the authors did not consider clinical decision support, which helps give providers the data tools they need to make appropriate care recommendations and the ability to exchange information electronically. These are two of the most critical features of certified EHRs, which have been shown in multiple well-designed studies to reduce unnecessary and duplicative tests.”