Despite the widely held assumption that having computer access to patients' test results will reduce testing, a new study shows that physicians who have such access to tests in the ambulatory care setting are more likely to order imaging and lab tests, according to a Health Affairs news release.
For their study, researchers from Harvard Medical School, Cambridge Health Alliance and City University of New York analyzed data from the 2008 National Ambulatory Medical Care Survey, which includes 28,741 patient visits to a national sample of 1,187 physician-based offices. The survey excludes hospital outpatient departments and offices of radiologists, anesthesiologists and pathologists.
Their assessment showed:
• Point-of-care electronic access to electronic imaging results, sometimes through an electronic health record, was associated with a 40-70 percent greater likelihood of an imaging test being ordered. Physicians without such access ordered imaging in 12.9 percent of visits, while physicians with access ordered imaging in 18.0 percent of visits.
• Women received more imaging studies overall than men, perhaps reflecting their use of mammograms and ultrasound studies but not more advanced imaging.
• Surgeons and other specialists were more likely to order imaging tests than primary care physicians.
The authors concluded office-based computerization may not yet reduce imaging use because current systems are cumbersome, insufficiently interoperable or lack effective decision-support software. The study does not examine the reasons for physician behavior when it comes to test ordering.
For their study, researchers from Harvard Medical School, Cambridge Health Alliance and City University of New York analyzed data from the 2008 National Ambulatory Medical Care Survey, which includes 28,741 patient visits to a national sample of 1,187 physician-based offices. The survey excludes hospital outpatient departments and offices of radiologists, anesthesiologists and pathologists.
Their assessment showed:
• Point-of-care electronic access to electronic imaging results, sometimes through an electronic health record, was associated with a 40-70 percent greater likelihood of an imaging test being ordered. Physicians without such access ordered imaging in 12.9 percent of visits, while physicians with access ordered imaging in 18.0 percent of visits.
• Women received more imaging studies overall than men, perhaps reflecting their use of mammograms and ultrasound studies but not more advanced imaging.
• Surgeons and other specialists were more likely to order imaging tests than primary care physicians.
The authors concluded office-based computerization may not yet reduce imaging use because current systems are cumbersome, insufficiently interoperable or lack effective decision-support software. The study does not examine the reasons for physician behavior when it comes to test ordering.
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