EHR use in ambulatory care would reduce cost growth, but has low rate of savings

There was good news and bad news in a new study on the costs versus benefits of electronic health-record use in ambulatory care.

First the good news. The adoption and use of EHRs by physicians in three Massachusetts communities appears to have reduced cost growth. Use of EHRs coincided with costs that were $5.14 per patient per month lower than projected, compared with a control group, according to a report appearing July 16 online in JAMA Internal Medicine.

The largest share of the reduced cost growth was in ambulatory radiology, at $1.61 per member per month over the study period.

The bad news is, at that rate of savings—about 3.4% over an 18-month period of EHR use and 47,979 patient interventions—it would take about 7 years to recoup the projected five-year adoption cost for EHR systems in the pilot communities. The costs amounted to $130,822 per provider, the authors concluded.

The physician EHR adoption costs in the researchers' calculations included software, hardware, training and lost productivity, according to the report's lead author, Julia Adler-Milstein, an assistant professor of information in the School of Information and an assistant professor of health management and policy in the School of Public Health at the University of Michigan.

The report ended on this hopeful note: “Reducing health spending by the magnitude that we observed would result in substantial savings if sustained over several years. Larger savings are possible if providers have incentives to deliver more efficient care. Efforts to reform financing and delivery of care alongside greater use of EHRs may focus clinicians' attention on how best to leverage their EHR to achieve savings and help realize the full benefit from our large national investment in EHRs.”

The research was funded by the Massachusetts eHealth Collaborative, a not-for-profit organization formed in 2004 to promote the use of health information technology and exchange whose member physician practices participated in the study.

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