HIT Might Increase Costs

Physicians with electronic access to test results were more likely order more tests than those who didn't have electronic access, which would increase costs rather than savings.

Health Affairs

Health information technology has been touted as an avenue to help reduce medical costs. Electronic access to test results and records can reduce diagnostic testing, thus saving money. However, a new study in is challenging that assumption and claiming that it might actually drive up costs.

According to the journal article, system features when a physician is electronically accessing test results might be enticing doctors to order more tests.

Physicians with access to computerized imaging results were 40% to 70% more likely to order an imaging test. The same thing was happening with lab test results — electronic availability of the results was leading to additional blood tests being ordered. Specialists were more likely to order imaging tests than primary care physicians.

Those doctors with access to electronic results ordered imaging test in 18% of appointments, while those without electronic access ordered tests in just 13%.

"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," said lead author Danny McCormick, a physician and assistant professor of medicine at Harvard Medical School, in a press release. "As with many other things, if you make things easier to do, people will do them more often."

The authors suggest that predicted savings from HIT were based on incomplete data.

However, there was no evidence that simply the presence of EHRs would lead to more testing. It was only the electronic access to results. As a result, the article suggests that it is the current implementation that’s leading to an increase in tests, and therefore costs.

Also, the data used was from 2008, and McCormick admitted InformationWeek Healthcare that at that time HIT didn’t appear to save money, “but there are a lot of caveats.”