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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EHR Innovators Part 2: drchrono

drchrono ehr digital health

This is the 2nd part in my round up of 4 EHR innovators that have caught my attention.  Last week I covered Practice Fusion.

Today I’m taking a look at drchrono.

Next week, we’ll check out hellohealth and
Avado.  There are other EHR/EMRs.  Lots.  Why aren’t they listed above?  They haven’t grabbed my attention yet.  Am I missing someone exciting?  Drop it in the comments!

In an earlier post I wrote about the top 5 features I need and my patients need in an innovative EHR: Integration, Web-based Interoperability, Mobility, Provider Sharing and Patient Access.  I’m evaluation how each of these EHR innovators does on meeting these top 5 features.

On to drchrono…

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EHR Innovators Part 1: Practice Fusion

As promised, this is the first in a multipart series, about the innovation going on in the Electronic Health Record space.  This isn’t meant to be a comprehensive review of all the EHR vendors out there.  It’s a short list of a few of the EHRs that have caught my attention for being innovative or exciting.  Those EHRs that make it easy and free to sign up I’ve evaluated first hand.  Those that don’t I’ve evaluated based on their own feature lists, demonstations and published materials.  This isn’t mean to be a usability evaluation, but just an overview of what’s being done out there.

So, here’s the group that has my attention:
Practice Fusion
drchrono
hellohealth
Avado
There are others.  Lot’s.  Why aren’t they listed above?  They haven’t grabbed my attention yet.  Am I missing someone exciting?  Drop it in the comments!

<begin digression>
A short digression on EHRs and disruption:  In my *ever-so-humble* opinion, the innovative EHR is not a truly disruptive technology, by strict definition.  Maybe Clay Christensen would disagree (in which case I would submit), or maybe history will prove me short-sighted and wrong.   But, I believe that in spite of the exciting innovation in this space, EHR innovation won’t replace or up-end any markets, particularly the market that it most directly influences: the Doctor-Patient(-Insurance) transactional market.  I do think EHR innovation may expand or create new markets.  It will reduce waste and inefficiencies.  It will improve care.  But it won’t truly disrupt the market.  It’s not going to take us from the realm of treatment/reaction medicine to preventative medicine.  It’s not going to change the payer models.  It’s not going to change the customer.  It doesn’t fit the pattern of disruptive technologies layed out in The Innovator’s Dilemma.  I see it as exciting evolution, but not revolution.
</end digression>

In an earlier post I wrote about the top 5 features I need and my patients need in an innovative EHR: Integration, Web-based Interoperability, Mobility, Provider Sharing and Patient Access.  I’m going to evaluate how each of these EHR innovators does on meeting my top 5 needs, starting with Practice Fusion.

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