Electronic health records and the frequency of diagnostic test orders.
Am J Manag Care
; 23(1): e16-e23, 2017 Jan 01.
Article
de En
| MEDLINE
| ID: mdl-28141935
ABSTRACT
OBJECTIVES:
To determine whether electronic health record (EHR) access influences the number of laboratory and imaging tests ordered, which is a frequently cited mechanism for EHR-enabled cost savings. STUDYDESIGN:
We analyzed data on non-federally employed office-based physicians from the 2008 to 2012 Electronic Health Medical Records Survey, a supplement to the National Ambulatory Medical Care Survey.METHODS:
We estimated logistic regressions to determine the relationship between EHR utilization and the volume of laboratory and imaging tests ordered in our study population, controlling for age, sex, race, clinic type, payer type, health status, comorbidities, and new patients.RESULTS:
Physicians who actively used an EHR system ordered more complete blood count (CBC) tests than physicians who did not (odds ratio [OR], 1.34; P <.001), even after adjusting for patient demographics, health status, and case mix. EHR-using physicians also ordered more computerized tomography scans (OR, 1.41; P <.001) and x-rays (OR, 1.39; P <.001); the difference for magnetic resonance imaging scans was not significant (OR, 1.08; P = .449). Subgroup analysis highlighted differences in ordering among various patient cohorts.CONCLUSIONS:
Using the most recent available nationally representative data, excluding federal and Veterans Affairs' hospitals, we found that physicians with EHR access ordered more tests than their non-EHR counterparts, thus contradicting a common rationale for EHR implementation. We argue that EHR use may actually increase healthcare expenditures by facilitating the ease of ordering tests. Whether these extra tests carry clinical utility requires further analysis.
Recherche sur Google
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Types de pratiques des médecins
/
Imagerie diagnostique
/
Tests diagnostiques courants
/
Dossiers médicaux électroniques
Type d'étude:
Diagnostic_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limites:
Female
/
Humans
/
Male
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Am J Manag Care
Sujet du journal:
SERVICOS DE SAUDE
Année:
2017
Type de document:
Article