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New study explains why EHR cost savings don't happen

Electronic health records deliver disappointing returns on investment, according to a new study published in the journal Health Affairs. The reasons why the technology has failed to make a meaningful impact on health care costs to this point will come as little surprise to many users.

The RAND Corporation researchers, Arthur Kellermann and Spencer Jones, suggest that EHR adoption has thus far failed to deliver lower costs because adoption has been slower than expected, clinicians have been reluctant to incorporate the technology into their workflows and there has been little progress toward interoperability.

A 2005 RAND paper projected that widespread EHR adoption would save the nation’s health care system $81 billion annually, the researchers point out. Yet even the most optimistic estimates of the impact of EHRs on costs fall well short of this.

The charge that EHRs lack interoperability is nothing new. Critics have been pointing to this as a flaw since the inception of the meaningful use program. This latest RAND paper will help cement for these critics the notion that subsidizing the adoption of EHRs without interoperability rules in place does little to support quality and cost improvements throughout the health care system.

The suggestion that unwillingness on the part physicians to make good use of the technology is holding back improvements also has a familiar ring to it. Physicians themselves often say they do not have the time to learn a new system or reshape the way they practice in order to accommodate the technology.

However, in their critique the researchers do see room for improvement for EHR adoption. They recommend that patients play a stronger role in facilitating the sharing of their own data among various providers and that EHR vendors reengineer their products to make them more interoperable. Additionally, physicians should be more willing to update their practices to make room for EHRs, the researchers say. While the book on EHRs may have been disappointing up to this point, the authors believe there’s still time to write a happier ending.

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And what about the concern that EHR effectively destroys patient privacy (HIPPA)
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I agree that the need for interoperatability is imperative to successful impact on decreasing healthcare expenses and increasing patient care. I believe the second biggest handicap is the physicans. As cited above, physicians are hesitant to change their workflows which impacts even an organization as a whole. Personal experiences in the last 6 months have revealed hospitalists that do not review charts prior to seeing chronic readmissions and  ER docs that do not review any EHR information for reoccuring ER visits for a chronic disease,both resulted in duplicate tests and inconsistent care for the patients.
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Interesting point about hospitalists not checking for chronic readmissions. My understanding was that that is supposed to be a reason for facilities employing hospitalists. Do you think Medicare penalties for high readmission rates could get hospitalists/ER docs reviewing records more?
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