EHS not a panacea: will it cost more?

"Quite possibly" is my takeaway from the New York Times article yesterday. Electronic health records (EHS) are being touted by the Bush administration and the tech industry as the savior of the health system - lower costs, better outcomes and so on. These promises are, of course, simplistic nonsense, the same sort of thinking that has eminated from certain "think tanks" over the past two decades. In the 1980s it was market forces, and now it's computers. Whatever.

Done well, EHS can improve efficiency for a practice physician by speeding up the lag within the office: finding charts, locating information in the chart, the need to be physically with a paper chart for it to be useful and so on. I have long contended that the key to practice efficiency is in the back -office, or support tasks, rather than simplly trying to cram more patients into the eight hour day.

The article argues that "An information revolution in health promises to be powerfully disruptive for some lucrative businesses in the industry, according to medical experts and economists, and could lead to more spending on health care instead of less." It discusses the experiences of Kaiser and the VA in using data to switch to cheaper drugs and personalizing the dosage. This kind of management can be done efficiently with good data that can be easily manipulated. The result is that certain "blockbuster" drugs may not be that great - useful, but not for everyone.

About 20% of physicians use EHR, and we are years away from full implementation. I believe that costs will drop as the products roll out, as the new safe harbor for hospitals and other to assist physicians in implementing EHR, and as newly graduated physicians enter the workforce and look to technology as a first resort.