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Digital health records may save some money: study

By Andrew M. Seaman

NEW YORK (Reuters Health) - Switching to electronic health records may lead to a small reduction in spending per patient at doctors' offices, according to a new study.

Researchers found that doctors' offices would be expected to spend about $5 less on the care of each patient per month after they started using electronic health records (EHRs), compared to doctors' offices that continued to use traditional paper records.

"I think - on the current path - there is a lot of reason to believe our findings will be true," said Julia Adler-Milstein, the study's lead author from the University of Michigan in Ann Arbor.

The U.S. government has committed about $30 billion to support the adoption of computerized medical records by doctors and healthcare systems across the country.

The hope is that the widespread use of EHRs will lead to better and less expensive care by reducing inefficiencies, inappropriate care and medical errors, according to the researchers, who published their findings in the Annals of Internal Medicine.

Previous studies, however, have found conflicting evidence on whether EHRs will truly reduce costs. Many concerns stem from the belief that the systems make it easier for doctors to order additional tests, which drive up spending.

For the new study, Adler-Milstein and her colleagues used data from healthcare providers in three Massachusetts communities that started using EHRs and providers in six other communities that continued using traditional paper records.

They had data on about 48,000 patients with EHRs between January 2005 and June 2009 and about 131,000 patients who continued with paper records.

Overall, there was no difference between the two groups in the total cost of medical care per patient per month, but a difference did emerge when the researchers looked only at ambulatory care - like the kind delivered at doctors' offices.

At the beginning of the study, the average cost of a patient's ambulatory care was $121.93 per month.

The cost increased to $140.46 per patient per month by the end of the study in the communities that continued to use paper records. That compared to $135.77 in communities that switched to EHRs.

When the researchers looked at where the cost savings were coming from in those offices, they found suggestions that there were reductions in the amount of money spent on laboratory and radiology tests.

"I think the fact that we found small savings was what I expected but we didn't know where it would come from," Adler-Milstein said.

The cost savings do not factor in any extra expenses of launching EHRs that would be paid by the doctors' offices themselves.

Dr. Rainu Kaushal, who wrote an editorial accompanying the new study, told Reuters Health she doesn't think EHRs will - themselves - lead to significant cost savings, but they're still necessary.

"EHRs may or may not directly contribute to those savings… but without investing in them you cannot achieve new models of healthcare delivery," said Kaushal, director of the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York.

Adler-Milstein said people who believe EHRs themselves would save money may be disappointed by the new findings, but those who understand it will take a combination of technology and healthcare delivery methods to save money will see the results as positive.

"I think it's just important to keep in mind how hard it is to really move an entire health system from paper to electronic records. So when we looked at these practices, I think it's a successful transition they made but… I would emphasize these are early stage results," she said.

SOURCE: http://bit.ly/11TM1jq and http://bit.ly/18j0MM9 Annals of Internal Medicine, online July 15, 2013.

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