Two groups of Harvard researchers last week reported separate study results showing health information technology systems do not save money. The author of one of the reports said that any claim that it does is "baseless propaganda."
That inspired several health officials, who are trying to improve quality and patient safety, to weigh in with their views. Here is what four health leaders think about whether electronic medical records can actually save money:
Jim Lott
Executive Vice President
Hospital Council of Southern California
Los Angeles
"Looking for savings in hospitals that use EMRs is short-sighted. The real payday for use of EMRs will come with interoperability. Measurable savings will be realized as middleware is installed that will allow for the electronic transmission and translation of patient records across different proprietary systems between delivery networks.
"The savings for hospital-centric EMRs will balloon when integration of these confined systems with the rest of healthcare delivery system is realized. The ideal circumstance would be the use of EMR smart cards that would be updated with every patient encounter and that can be read electronically by every medical provider treating the patient, regardless of the providers' medical network or health plan affiliation.
"This virtual integration will facilitate more accurate and speedy patient assessments, diagnoses and treatment plans, and it will reduce duplicate and unnecessary imaging and laboratory tests, as medical providers will have immediate access to the most recent work done on patients both in and outside their own delivery networks."
Neil R. Powe, MD, MPH, MBA
Chief of Medical Services
San Francisco General Hospital
Constance B. Wofsy Distinguished Professor and
Vice-chair of Medicine
University of California San Francisco
"The paper as I see it tried to accomplish a lot. One limitation is that they used rather blunt measurement to assess the information systems.
"You can have all the components of the information system in place, but if they are not being used by physicians, one might not see an effect. In contrast, our study measured whether physicians are aware of the components and how physicians are using the components of the information system.
"Physician order entry and decision support I believe offer the most chance of improving healthcare delivery. There are a lot of information systems with bells and whistles that don't focus on physicians' real needs."
Robert M. Tennant, MA
Senior Policy Advisor
Medical Group Management Association
Washington, D.C.
"The government has clearly spoken. It says we want to spend billions to get the vast majority of physicians up and running on electronic medical records.
"The fact that they front-load the money means they want it to happen in a hurry. We agree with that too. We're excited about it. But if the program is developed in a way that it doesn't facilitate that, we're looking at potential failure. If they make it so difficult to participate in the program, it's going to fail."
Johnny Walker, MBA, CPA
Founder and past CEO of Patient Safety Institute
Plano, Texas
"EMRs don't save money in standalone situations. However, EMRs will absolutely save significant money (and improve care and safety) when connected and sharing clinical information.
"The reason VA and Kaiser see savings where other hospitals don't is because of the degree of connectivity and clinical information-sharing related to individual patients.
"The savings grow geometrically following the Law of Externalities. Currently we are still at the beginning of the information sharing curve and therefore the cost saving curve. We have taken our eye off the successful VISA example. Information connectivity and access drives [EMR] adoption; not the other way around."