Dive Brief:
- A study in the July issue of Health Affairs concludes that hospitals aren’t using electronic health records inappropriately for financial gain from Medicare.
- Researchers from the Harvard School of Public Health and University of Michigan compared billing records from 393 hospitals using EHRs to 782 hospitals still using paper records. They matched hospitals in terms of size and status as teaching hospitals or for-profit companies. "To my surprise, we found nothing," one researcher said. "We found that electronic health records didn't really change billing practices at all."
- But an expert in the field said that researchers looked at inpatient data when they should have examined outpatient and ER data.
Dive Insight:
HHS and the Justice Dept. sent hospitals a letter in 2012, warning them against using EHRs inappropriately. That occurred after the Center for Public Integrity and New York Times reported that some hospitals using electronic records were billing Medicare significantly more than were those hospitals still using paper records. Now comes this study disputing that finding.
Yet Dr. Donald Simborg, a pioneer in the field of electronic health records, told Kaiser Health News that this latest study doesn't touch upon the area he believes is key. "They're looking in the wrong place," he said. "I don't think anybody's done the study that needs to be done."
The real area of concern is in emergency departments and outpatient clinics, an increasing number of which are owned or run by hospitals, asserted Simborg, who began designing computerized patient records in the 1960s and more recently led government advisory panels on how to guard against fraud in digital health records.
For years, hospitals have used software that helps them to maximize billing for inpatient stays, Simborg said. What's new is that doctors in emergency rooms and clinics are just now getting digital record keeping tools, which sometimes prompt them to over-document. He said he's actually seen this over-documenting when he's watched doctors use electronic records he designed.