Using electronic health records to save money
- Yosefa Bar-Dayan1,2,3,
- Halil Saed1,
- Mona Boaz3,4,
- Yehudith Misch1,
- Talia Shahar1,
- Ilan Husiascky1,
- Oren Blumenfeld1
- 1Medical Corps, Israel Defense Forces, Tel Aviv, Israel
- 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- 3Diabetes Unit, Wolfson Medical Center, Holon, Israel
- 4Epidemiology and Research Unit, Wolfson Medical Center, Holon, Israel
- Correspondence to Dr Yosefa Bar-Dayan, Diabetes Unit, Sackler Faculty of Medicine, Wolfson Medical Center, Tel Aviv University, Holon, Israel;
- Received 17 November 2012
- Revised 17 January 2013
- Accepted 7 February 2013
- Published Online First 5 March 2013
Objectives Health information technology, especially electronic health records (EHRs), can be used to improve the efficiency and effectiveness of healthcare providers. This study assessed the cost-savings of incorporating a list of preferred specialty care providers into the EHRs used by all primary care physicians (PCPs), accompanied by a comprehensive implementation plan.
Methods On January 1, 2005, all specialty clinic providers at the Israeli Defense Forces were divided into one of four financial classes based on their charges, class 1, the least expensive, being the most preferred, followed by classes 2–4. This list was incorporated into the EHRs used by all PCPs in primary care clinics. PCPs received comprehensive training. Target referral goals were determined for each class and measured for 4 years, together with the total cost of all specialist visits in the first year compared to the following years. Quality assessment (QA) scores were used as a measure of the program's effect on the quality of patient care.
Results During 2005–2008, a marginally significant decline in referrals to class 1 was observed (r=−0.254, p=0.078), however a significant increase in referral rates to class 2 was observed (r=0.957, p=0.042), concurrent with a decrease in referral rates to classes 3 and 4 (r=−0.312, p=0.024). An inverse correlation was observed between year and total costs for all visits to specialists (2008 prices; r=−0.96, p=0.04), and between the mean cost of one specialist visit over the 4 years, indicating a significant reduction in real costs (2008 prices; r=−0.995, p=0.005). QA was not affected by these changes (r=0.94, p=0.016).
Conclusions From a policy perspective, our data suggest that EHR can facilitate effective utilization of healthcare providers and decrease costs.