Computerization May Not Curb Medical Tests, Costs

Doctors order more scans if they have easy access to results, study shows

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_122624.html (*this news item will not be available after 06/04/2012)

By Mary Elizabeth Dallas

Tuesday, March 6, 2012

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Diagnostic Imaging

TUESDAY, March 6 (HealthDay News) -- Doctors are more likely to order imaging and other diagnostic lab tests for their patients if they have computer access to the test results, according to a new study.
Although this technology was intended to reduce costs and increase efficiency, researchers from Harvard Medical School found easy access to test results was associated with a 40 percent to 70 percent increase in imaging test orders. Computerization actually could be driving costs up, they said in the study, published in the March issue of Health Affairs.
"Our findings should at a minimum raise questions about the whole idea that computerization decreases test ordering and therefore costs in the real world of outpatient practice," study author Dr. Danny McCormick, an assistant professor of medicine at Harvard, said in a journal news release. "As with many other things, if you make things easier to do, people will do them more often."
The researchers examined national survey information on almost 29,000 patient visits to nearly 1,200 doctors. Radiologists, anesthesiologists and pathologists were excluded.
The study found that doctors without computer access to test results ordered imaging in 12.9 percent of visits. Those who did have computer access to results ordered these tests in 18 percent of visits.
The study noted that women underwent more imaging studies than men, perhaps because of mammograms and ultrasounds, and specialists were more likely than primary care physicians to order these tests.
Previous studies estimated that computerization in doctors' offices would save more than $8 billion each year in reduced imaging and lab testing. The researchers said these studies were limited since most medical practices are not equipped with cutting-edge computer systems.
The study authors also noted that even offices with the latest equipment had high rates of testing. They concluded that curbing patient referrals patients to a medical imaging center in which a physician has a financial stake may be more effective in decreasing testing.
They added that their findings "emphasize the importance of establishing the benefits of computerization rather than estimating them in the absence of data, or generalizing from small studies at a few atypical institutions."

SOURCE: Health Affairs, news release, March 5, 2012

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