Harvard, U Penn profs: EHRs don't save money

Despite government "hype" and billions of dollars in incentive payments, electronic health records don't actually reduce healthcare costs or improve patient care, according to two healthcare academics.

Claims that EHRs save money rarely include the full cost of installation, training and maintenance, Stephen Soumerai, a professor of population medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute and Ross Koppel, a professor of sociology and medicine at the University of Pennsylvania and principal investigator of its Study of Hospital Workplace Culture wrote in an op-ed the Wall Street Journal.

They also noted that the software is "generally clunky, frustrating, user-unfriendly and inefficient."

Lack of standardization among EHR systems is hindering their potential, the authors wrote. "Instead of demanding unified standards, the government has largely left it to the vendors, who declined to cooperate, thereby ensuring years of noncommunication and noncoordination. This likely means billions of dollars for unnecessarily repeated tests and procedures, double-dosing patients and avoidable suffering," they pointed out.

They also stated that data sharing, a "central component" of EHRs, has failed due to this lack of standardization.

Some commenters on the article noted that electronic records still are a huge step forward. 

"EMRs may not be working well ... yet," one commenter wrote. "However, I ran physician practices during paper record times and I know how poorly that method functioned. Don't believe for a second that paper records are better. They aren't. They get lost, they are always incomplete, they are not secure, handwriting is impossible to read, etc. etc. etc. I agree that EMRs are definitely not working well yet. But going backwards to paper is not the solution."

The authors base their argument on studies, including one from McMaster University in Hamilton, Ontario. "With a few isolated exceptions, the preponderance of evidence shows that the systems had not improved health or saved money. For instance, various studies found the percentage of alerts overridden by doctors--because they knew that the alerted drug interactions were in fact harmless--ranging from 50 percent to 97 percent," they wrote.

Indeed, studies have shown that EHR success varies significantly depending on location, training and other factors--and for as long as there's been electronic health records, there's been conflicting studies about the effectiveness and return on investment of EHRs.

And a recent analysis by the Center for Public Integrity determined that electronic health records might actually be the cause of higher billing rates due to upcoding by some doctors.

"This is a new era for investigators," Jennifer Trussell, who directs the investigations unit of the U.S. Department of Health & Human Services Office of Inspector General, said, according to an article on the CPI website. "We are all excited about the many benefits of electronic health records, but we need to be on the lookout for unscrupulous providers who take advantage of this new technology."

To learn more:
- here's the WSJ opinion piece
- see the comments page
- check out the CPI article