Ambulatory EHR adoption doesn’t impact total cost: Study

The use of electronic health records (EHRs) saved more than 3% in ambulatory health costs but did not reduce overall inpatient costs, according to a new study.

Published in the July 16, 2013, issue of Annals of Internal Medicine, the study was led by Julia Adler-Milstein with the University of Michigan in Ann Arbor, Mich.

Adler-Milstein and colleagues based the findings on 806 ambulatory clinicians across 3 Massachusetts communities that adopted subsidized EHRs. The study group was comprised of 47,979 intervention patients and 130,603 control patients. The researchers reviewed monthly standardized healthcare costs from commercial claims data from January, 2005, to June, 2009, including total cost, inpatient cost, and ambulatory cost-including pharmacy expenses.

They found that ambulatory EHR adoption did not impact total cost, but the results favored savings (95% CI, $21.95 projected savings per member per month (PMPM) to $1.53 PMPM in higher costs). However, EHRs slowed ambulatory cost growth (-0.35 percentage point) and projected ambulatory savings were $4.69 PMPM.

“Using commercially available EHRs in community practices seems to modestly slow ambulatory cost growth,” Adler-Milstein wrote. “Broader changes in the organization and payment of care may prompt clinicians to use EHRs in ways that result in more substantial savings,” she added.

However, a limitation of the study was that intervention communities were not randomly selected and received implementation support, suggesting that results may represent a best-case scenario, according to the researchers.å