{"id":2798,"date":"2012-03-06T17:47:38","date_gmt":"2012-03-06T22:47:38","guid":{"rendered":"http:\/\/www.healthit.gov\/buzz-blog\/?p=2798"},"modified":"2026-01-06T15:10:35","modified_gmt":"2026-01-06T15:10:35","slug":"study-facts","status":"publish","type":"post","link":"https:\/\/healthit.gov\/blog\/insights-updates\/study-facts\/","title":{"rendered":"Recent Study: Get the Facts"},"content":{"rendered":"\n

Apparently, doctors who order a lot of imaging tests are more likely to have electronic systems that let them view those images in their offices.<\/p>\n\n\n\n

That is the finding of an article appearing in the March 2012 issue of Health Affairs<\/em> by McCormick and colleagues. This is not a particularly surprising observation. What is surprising is that the authors go far beyond the scope of their research to conclude that \u201cthe federal government\u2019s ongoing, multibillion-dollar effort to promote the adoption of health information technology may not yield anticipated cost savings from reductions in duplicative diagnostic testing. Indeed, it is possible that computerization will drive costs in this area up, not down.\u201d <\/p>\n\n\n\n

While such interpretations may make for attention-getting media headlines, it\u2019s important to get the facts. There are several reasons why McCormick\u2019s study ultimately tells us little about the ability of electronic health records (EHRs) to reduce costs, and why it tells us nothing about the impact of EHRs on improving care.<\/p>\n\n\n\n

The Study Was Not About EHRs At All, Much Less Their \u201cMeaningful Use\u201d<\/strong><\/h2>\n\n\n\n

McCormick\u2019s article considered how physicians react to electronic viewing of imaging results, not EHRs. In fact, when the authors  looked at EHR use, they found that “use of an electronic health record system showed no association with test ordering<\/em>.\u201d Also, the study data were from 2008, before the passage of the HITECH Act and the linking of payment incentives to the meaningful use of EHRs.<\/p>\n\n\n\n

Moreover, the authors did not consider clinical decision support, which helps give providers the data tools they need to make appropriate care recommendations and the ability to exchange information electronically. These are two of the most critical features of certified EHRs, which  have been shown in multiple well-designed studies to reduce unnecessary and duplicative tests.<\/p>\n\n\n\n

The Study Falls Prey to the Classic Fallacy of Using Association to Suggest Causality <\/strong><\/h2>\n\n\n\n

Ordering more tests may lead to buying an image viewing system, not the other way around. As my predecessor David Brailer pointed out in the New York Times<\/a> <\/em>, this was not a randomized trial, but an observational study (the National Ambulatory Medical Survey) that was not designed to answer the question of cost, or associations between EHRs and quality.<\/p>\n\n\n\n

As a result, many other variables that could affect physician behavior could not be examined in this study, including:<\/p>\n\n\n\n