EHR study continues to spark discussion

Health IT alone is not the panacea for reducing healthcare costs system-wide, but it’s “a very important and credible aspect,” according to Justin Barnes, vice president government affairs at Greenway Medical Technologies.

Barnes’ comments come in response to the recent debate between Farzad Mostashari, MD, the National Coordinator for Health Information Technology and researchers who published a study in the March issue of Health Affairs. The study concluded that physicians who view diagnostic images electronically are more apt to order follow-up tests, hence raising the cost of healthcare.

Lead author of the study, Danny McCormick, MD, assistant professor of medicine at Harvard Medical School, and his co-authors said Mostashari’s defense of EHRs as a money-saving strategy is “wishful thinking.”

Mostashari said the research wasn’t valid.

According to Barnes, lowering healthcare costs will require the merging of new payment structures, technology and liability safe harbors.

“It’s true that quality, outcomes and individual payments were not completely addressed in the imaging study, and it’s true that technology can be an enticement for deep-dive diagnostics,” Barnes said, “but I believe that if all of the delivery reform elements come together as communities of care connecting doctors as much as data, then costs related to hospitalizations and even testing will be decreased.”

Then, the decreases will show up in larger, randomized studies that could quell much of the case-by-case debate, he added.

“We know that EHRs and related technologies can decrease costs per practice," Barnes said. "To prove those savings have a ripple effect, and again that system-wide costs can be decreased, is just a matter of time and further study."

Davies Award winner Samuel Lederman, MD, an OB/GYN physician from Palm Beach, Fla., and clinical trial researcher for 15 years, said the research drew some unsubstantiated conclusions. “You have to do it right, and it’s hard to do it right,” he said of the research.

The first weakness of the study is that it looks back at data, rather than collecting it forward, Lederman said. Another is that the study did not examine the types of tests physicians ordered for follow-up. Perhaps the follow-up tests were common for that sort of diagnostic test. For example, one-third of all mammograms require additional imaging, Lederman said. The study needed to include whether or not the tests were required and if they in fact improved care for the patient.

“This is interesting data; it points to further study,” Lederman said. “At the end of the day, it’s about quality of care.”

In their response to Mostashari, the researchers said they are glad the study is opening up a debate.

Follow Diana Manos on Twitter @DManos_IT_News.

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