|...for Better Health and Savings?|
It's been awhile since the DMCB looked critically at the latest news on the unending assertion that the EHR is somehow going to "save money" and reduce U.S. health care costs. This well written article by Gary Baldwin includes interviews with a wide-ranging number of HIT leaders and, to the non-surprise of the DMCB, the evidence of savings - as of June 2011 - remains very much an open question.
The issues are the same: what a physician practice may save in filing and transcription costs is lost in hardware, maintenance and IT personnel support costs. While there may be some ultimate gains in office efficiencies, it can take months before patient flows return and even then, it's back to baseline. Claims of meaningful jumps in clinical quality are overblown, the impact on repeated unnecessary testing is questionable and clunky user interfaces can not only be frustrating to doctors, but lead to new types of medical errors. And in the middle of all that, the real business case for the EHR lies in its ability to document additional "billable" care, enabling providers to bill more for the same services.
With the ballyhooed reliance of federal and state health policymakers on "evidence" and "science," the DMCB finds it ironic that so much of our nation's treasure is being used by CMS to promote what is more an ideology than a clinical discipline.
This makes the DMCB ask one simple question: if the EHR really saves money, can anyone point to one instance where the installation of an EHR led to a drop in hospital or physician office prices and lower expenses for patients or their insurers? If not, why not?