Health care’s unintended consequences

In the effort to reduce medical costs, computerizing records and making patient history more accessible to doctors doesn’t seem to be working.

Doctors who have easy computer access to results of X-rays, CT scans and MRIs are 40 to 70 percent more likely to order expensive tests than doctors without electronic access, the Washington Post reports this afternoon on a study to be published in the March issue of the journal Health Affairs.

It’s a challenge to the notion that health information technology can cut costs.

Researchers found that doctors who did not have computerized access ordered imaging tests in 12.9 percent of visits, while doctors with electronic access ordered imaging in 18 percent of visits, a 40 percent greater likelihood. Doctors with computerized access were even more likely — about 70 percent — to order advanced imaging tests, such as PET scans, which experts said are most commonly used to detect cancer, heart problems, brain disorders and other central nervous system disorders.

The study found the results hold true even after taking into account other factors, such as patient demographics, doctor specialty and physician self-referral.

Researchers were not able to determine why physicians ordered the imaging tests, or whether in those cases, physicians had looked at patients’ prior chest X-rays. Nor were they able to assess whether the increased imaging helped or harmed patients.

The data also didn’t indicate whether a doctor’s computer system had sophisticated features, commonly known as online clinical decision support, that help doctors make treatment decisions.

Electronic patient records has been a key part of modernizing health care.

Full article here.