EHRs can reduce unnecessary care; best approach unclear

EHR system
The ability for EHRs to collect data and intervene with automated alerts offers tremendous potential.

EHRs can be a critical tool in deterring physicians from ordering unnecessary tests. Unfortunately, researchers say the ideal approach is still unclear.

Movements such as the Choosing Wisely campaign have highlighted the impact of unnecessary testing and procedures, although research shows it has not decreased the number of unnecessary tests ordered by physicians.

Still, the ability for EHRs to collect data and intervene with automated alerts offers tremendous potential in addressing overutilization, even though health systems have yet to find the most effective approach, researchers wrote in JAMA Viewpoint.  

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The authors outlined three scenarios in which EHRs have been used to address unnecessary testing:

  • Using the Choosing Wisely recommendations to create automated alerts that provide physicians with evidence and alternative options
  • Aggregating data to compare physician orders against one another
  • Mining each patient’s history to provide physicians with best practices prior to a visit

As of now, it’s still unclear which of these scenarios has the biggest impact, and the authors note that the optimal approach depends on each institution’s culture.  

“The EHR has the potential to be a powerful vehicle for measurement and intervention around low-value care,” the researchers wrote. “While innovative organizations have adopted several EHR-based approaches to reduce low-value care, the best choices remain to be determined, and combinations may work best.”

Although overuse of diagnostic procedures has declined in recent years, overall spending on low-value care remains high, reaching an estimated $32.8 million annually.

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