Just one day after the Health Affairs article that showed an association between physicians' Electronic Health Record (EHR) use and increased ordering of diagnostic imaging the chief of the Office of the National Coordinator for Health Information Technology (ONC HIT), Dr. Farzad Mostashari has writen a scathing piece in the Health IT Buzz blog blasting the author's conclusions as "far beyond the scope of their research".
Dr. Mostashari points out the following:
- The Original Study Was Not About EHRs At All, Much Less Their “Meaningful Use”
- The Original Study Falls Prey to the Classic Fallacy of Using Association to Suggest Causality
- The Original Study Did Not Consider the Appropriateness of Imaging Tests
- Reducing Test Orders Is Not the Way that Health IT Is Meant to Reduce Costs
Essentially, Dr. Mostashari is serving as a government mouthpiece trying to poke holes in a study that questions the effectiveness of the 2009 American Recovery and Reinvestment Act (ARRA) that provides $25.8 billion in stimulus funding, much of to physicians and hospitals who purchase Electronic Health Records.
Dr. Ray, one of the commenters to Dr. Mostashari's blog post points out that the burden of proof is on the government to show that EHRs actually work to bring down costs.
And, quoting the original authors:
"History urges caution in assuming that advances in medical technology will result in cost savings. In fact, the opposite is more often the case."Medical imaging costs will most likely rise as physicians gain increased access to image-viewing features of EHRs.
And, as I originally pointed out, critical pathways for high-cost conditions treated by physical therapists will become increasingly popular, driven by payers frustrated by soaring medical imaging costs.
What say you?