EHRs and Health Information Exchange: Will increased access decrease costs?

The federal dollars in the HITECH act, and much of the enthusiasm for new innovation in the healthcare IT space is predicated on the assumption that better access to information will result in better and cheaper care.  Avoiding unnecessary duplicated studies, especially, expensive medical imaging, is one way that’s supposed to happen.

As a medical imaging specialist, I can attest to the fact that unnecessary and wasteful imaging tests get ordered all the time, at significant cost.  It see it many times a day, and I’m a believer in the power of increased access to health records.

Two articles have recently been published in the medical literature that aim to test this assumption.  And the results seem to be in conflict.  The first article, published in the Journal of Health Affairs, examined access to medical imaging and results, and found that physicians with electronic access were actually more likely to order additional imaging tests.  The second article, published in the Archives of Internal Medicine, found that doctors ordered 49% fewer lab tests after the introduction of an electronic health information exchange (HIE).

So, what are we to believe?  I’ll try to make some sense of this.

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