Electronic health records have just received a second big setback. Last year the RAND corporation released a report showing that EHRs hadn’t saved the health care system any money. It caused a big stir at the time because the Affordable Care Act had set aside more than $22 billion to promote EHR programs under the assumption we would see at least some cost savings. Now, the New York Times reports, a new study has found that EHRs might even increase costs across the health care system by leading providers to overbill for services. Unlike written records, EHRs allow doctors to copy and paste patient information from the records of previous patients into forms documenting a new, similar but not identical series of treatments. But this creates room for lots of potential errors if doctors copy and paste information into the wrong field, as an earlier piece from Health Care IT News explained:
[Health care expert Diana Warner] recalled an incident at her previous medical group where a patient went from having a family history of breast cancer to having a history of breast cancer, all from copy and paste errors. It was a nightmare, said Warner, and took months to fully resolve. “The insurance company caught it and was going to change (the patient) coverage because she lied,” so they thought, said Warner. “We had to work for months to get that cleared up with the insurance company so that her coverage would not be dropped. We had to then find all the records that it got copy and pasted into” incorrectly. Then, they had to track down all the locations they sent that information.
It’s not only errors like this that inflate costs; EHRs also present opportunities for fraud. It can be harder to track where inaccurate information came from, and if nobody edits the forms, one can easily get away with listing more procedures, or more expensive procedures, than the doctor actually performed on the patient.This story doesn’t mean that electronic health records as a whole aren’t promising. The problem, rather, is that the ACA poured billions into a technology that hadn’t been fully tested. The problems with EHRs mostly spring from the failure of government agencies to carefully observe them in action on a smaller scale, and then to develop proper standards to make the technology effective on a larger scale. Pushing forward new programs or technologies before we fully understand how they work best is a textbook central-planning fail.