Doctors Using Electronic Health Records Order More Tests, Study Finds

Electronic health records could encourage physicians to order imaging tests more frequently, raising questions about whether the technology can help reduce medical costs, according to a study published Monday in the journal Health Affairs, the New York Times reports (Lohr, New York Times, 3/5).

The study, conducted by the Cambridge Health Alliance, analyzed data from the 2008 National Ambulatory Medical Care Survey on 28,741 patient visits to 1,187 office-based physicians (Gold, "Capsules," Kaiser Health News, 3/5).

Study Findings

Researchers found that physicians with electronic access to patients' previous imaging results ordered tests 40% more frequently than those using paper records. Doctors with EHRs ordered tests on 18% of visits, compared with 12.9% for physicians who used paper records.

The study also found doctors with EHRs ordered more advanced and costly imaging, such as MRI tests and CT scans, 70% more frequently than those with paper records.

Although the study did not explore the reasons physicians who use EHRs order more tests, the researchers said the technology could make ordering tests easier (New York Times, 3/5).

Danny McCormick, lead author of the study, said, "As with many other things, if you make things easier to do, people will do them more often" (McKinney, Modern Healthcare, 3/5).

Study Raises Questions About Cost Savings

The study comes as the federal government plans to provide up to $27 billion in incentives through the meaningful use program to encourage health care providers to transition to EHRs, in the hope that the technology will help rein in health care spending (Sun, Washington Post, 3/5). Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Proponents of EHRs have said that they help reduce unnecessary and duplicative testing by providing physicians with better and more up-to-date information when treating patients.

However, McCormick said the research "raises real concerns about whether health information technology is going to be the answer to reducing costs."

Experts Criticize Methodology

Many health policy experts were critical of the study's methods, noting that the survey data predate the meaningful use incentive program and standards that launched last year (New York Times, 3/5).

Michael Furukawa, a health economist in the Office of the National Coordinator for Health Information Technology, said the focus of the study was limited. "The proper use of advanced health IT functions, we believe, will reduce costs in the long run," he said (Washington Post, 3/5).