Do EDR Systems Really Lead to More Tests?

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The potential benefits of EDRs have been the subject of many a heated discussion online in multiple forums. Some advantages are plainly apparent – like the ability to auto fill certain fields like address or list of allergies from a previous visit. Others only became obvious with repeated usage.

One benefit that proponents of EDRs have talked about is that it would lower costs by reducing the number of tests. Why would using an EDR reduce the number of tests that patients need? EDRs can help in a number of ways. Doctors can easily find past results, reducing the need to repeat them simply because the old results cannot be found. Since the complete record of previous tests is readily available, the probability of ordering the same test by mistake also goes down.

Do EDRs Reduce the Number of Tests?

Most practices and hospitals have long since adopted EDR systems. Researchers now have plenty of data to work with in regards to EDR usage. So what can we learn about the frequency of ordering tests with and without an EDR in the clinic? A recent study set out to verify if using an EDR had any influence on test frequency.

The results may be surprising to some people. Researchers found that doctors actually ordered more tests after switching to an EDR system from paper. Does this mean EDRs don’t actually help to decrease costs of healthcare?

Before we jump to conclusions however, we must remember that studies such as this one have their limitations. In the past, some research found that EDRs increased costs for certain hospitals while other studies found the opposite. A lot depends on the methodology and test subjects. Until there are numerous studies that show the same trend, we can’t actually say if EDRs reduce or increase the number of tests ordered for patients.

Why Would EDRs Increase Frequency of Tests?

Let’s look at a few reasons why this can happen. One interesting hypothesis could be that EDRs enable doctors to get a better view of patient health in one place. You can see past medical history, current symptoms, list of medications, allergies and habits etc in one place. It may highlight the need for certain tests, something that might have been skipped if the physician didn’t have access to all the data. So you have doctors ordering more tests simply because they’re necessary.

Another reason could be that EDRs make it easier to order tests and for patients to get them done. With paperwork, there could be situations where doctors never ordered some tests because it would take too long to setup or it was too difficult to order. Now that the process is easier, we see an increase in testing. But we should keep in mind that these might just be tests that should have been ordered anyway to help with diagnosis.

One of the problems with research studies such as this one is that while they can control for a lot of variables like age, demographics etc. they haven’t distinguished tests based on necessity. So while this particular study notes an increase in testing, we don’t really know if they were necessary or not. Another study may conclude that necessary testing increased but unnecessary ones declined due to EDRs.

Even if EDRs don’t reduce the number of tests being ordered, they do present many benefits in this area. You can get test results quicker than with paper and make an accurate diagnosis. It will ultimately lead to better patient care by eliminating delays. It is true that certain benefits can take time to materialize. But on the whole, EDRs are making life better for patients and physicians.

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