A recent study of physician EHR use found that the technology could be responsible for increasing spending in a hospital setting.
Since EHR technology has the potential to benefit the healthcare system overall, the healthcare industry has steadily sought technological advancement and optimization over the past several years. The Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009 accelerated the effort in the area of EHR implementation by introducing incentive payments as motivation for individual providers and hospital systems to demonstrate meaningful use of EHR systems prior to the advent of the Quality Payment Program. An estimated $30 billion was allotted to this incentive program.
In 2005, RAND predicted EHR implementation would save the healthcare industry $81 billion a year.
However, researchers in 2012 reassessed the financial benefits of EHR implementation and reported instead an adverse effect on healthcare costs totaling $800 billion. This realization does not counteract the projected benefits of EHRs, but it does raise some doubts as to the true cost benefits possible through EHR adoption.
Decreasing healthcare spending is touted as a potential benefit of EHR implementation, but recent research has offered little encouragement. To explore this question further, Hakim et al. recently conducted a study to assess whether EHR access influences the amount of diagnostic tests ordered. While EHR use may improve patient care and lead to administrative advantages, the rising cost of test ordering may negate its advantages as a money-saver for clinicians and physicians.
In their study, researchers found physicians who utilize EHR systems ordered more complete blood count tests than physicians who did not use EHR systems. These findings back the kind of conjectures made in 2012 regarding the counterproductive cost repercussions of computerized health information.
Researchers found that availability of EHR use was correlated with higher rates of complete blood count (CBC) testing for patients of all demographics over 25 years of age. In addition, researchers noticed the same trend for Medicare and private insurance beneficiaries.
In their analysis, researchers saw two distinct possible causes for the increase in test ordering: either online access to EHRs simplifies the ordering process so much that more providers are able to order tests more frequently, or physicians who are willing to adopt EHR systems are also generally more inclined to order more tests for their patients.
Evidence strongly points to the first interpretation, and researchers suggest the ease with which EHR use allows for test ordering is both beneficial and potentially expensive. The limited hassle appears to make providers trigger-happy with test ordering, ultimately leading to increased hospital spending.
With these results in mind, researchers suggest policymakers and physicians take three steps to improve their approach to EHR implementation in the interest of reducing healthcare expenditures:
First, researchers suggest policymakers and physicians reassess their expectation that EHR use can reduce medical expenditures and increase clinical efficiency. By repositioning EHR use less as a means of saving money and more as a means of streamlining patient care, providers can begin to look for ways to cut costs through more realistic means.
These methods of cutting costs could be focused more on organizational, administrative, or delivery-centric policies. Researchers concluded since EHR adoption is insufficient to reducing overall healthcare expenditure, providers must encourage organizational and delivery processes helpful in achieving industry-wide savings.
Lastly, researchers advised providers implementing EHR systems build a model of care around these systems that maintain a focus on quality, value, and efficiency.
While cost efficiency may not be as much of a focus in these future models, providers can emphasize the other advantages EHR implementation has to offer.