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.

  • Beth-Ann Bloom

    It is likely that there were significant differences between the styles of practice of doctors with and without access to electronic records that impacted this decision and were not controlled for in the study,

  • allie

    Rule # 1 in assessing these sorts of studies: Correlation does not imply causation.

    Beth-Ann makes an excellent point to this end.

  • Betsy

    Correct. Correlation does not imply causation. But this finding certainly warrants more study.

  • Mississippi River

    The question may be to ask , did Minnesota and the Governor leap before the reality of effects on those most effected by these changes . Changes however that seem more of a role taken by our State as a conservator role . A role that no one would want to have if they had the opportunity to say how or what they need or wanted . A role that may expedite matters and ease the cost to the state in the Health care areas . However many did not have a choice of this changes and now find that a private company has information that you and I would not want them to have . Is it that they were in need and had to ask our State for help that our State felt that they could take this step forward . Does venerability for the State look like and open door as it may for many in society . Or is it in this matter they just wanted to find an easy way to get things done . In either case . The effects will and are being felt . Effects on the citizens of Minnesota our family and neighbors . Each citizen no matter what classification are State may deem them may need to reflect on their human , civil and personal rights to make choices for themselves . As you and I would want . As our Governor would want . We each must be able to be our own governor and apart of our own health care . If not we are then just what others may find easiest to expedite .