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Do EHRs Actually Increase Healthcare Costs?

Physicians with electronic access to imaging test results are inclined to order a greater number of scans, calling into question the true cost savings of adopting health information technology, according to a Health Affairs study.

Doctors who reference computerized imaging results are 40% to 70% more likely to order imaging tests than physicians working off of paper records, say the study's authors, who analyzed the records of nearly 29,000 patients who visited around 1,200 office-based physicians in 2008.

The authors note that electronic access to medical records may increase test ordering because of system features that make it easy to do so. The use of "health information technologies, whatever their other benefits, remains unproven as an effective cost-control strategy with respect to reducing the ordering of unnecessary tests," they say.

IT advocates, however, dispute the study's findings. David J. Brailer, MD, PhD, who in 2004 was appointed the nation's first National Coordinator for Health Information Technology, told The New York Times that the study's conclusions were based on a correlation in the data and not the result of a controlled test.

In addition, the research assessed the electronic viewing of imaging results, not the meaningful use of EMRs, says Farzad Mostashari, MD, ScM, the national coordinator for health information technology at the U.S. Department of Health and Human Services.

Dr. Mostashari also points out that the study didn't address clinical decision support and the ability to exchange information electronically - key features of certified EHRs that have been shown to reduce unnecessary and duplicative tests.

"The ultimate impact of EHRs on reducing costs will be through improvements in the coordination and quality of care, and the prevention of unnecessary and costly complications and hospitalizations," says Dr. Mostashari.

Daniel Cook

FDA Suggests Separate Bottles for Post-Op Eye Drops

An FDA advisory committee has voted against product labeling that states a single bottle of anti-inflammatory eye drops could be used post-operatively to treat 2 individual eyes.

The committee recently met to discuss the approval of an increased fill size of an anti-inflammatory eye drop for patients undergoing cataract extraction surgeries in both eyes. The use of a single, larger bottle let allow patients undergoing the surgeries treat each eye using a single bottle. In voting against the use of these larger bottles, the FDA noted that doctors frequently instruct patients to use separate eye drop containers for each eye after surgery, due to concerns of contamination and the possible transfer of bacteria between eyes.

The FDA is now considering the potential need for special post-op eye drop packaging - such as dual packs and bottles specially designated for right and left eyes - for patients who've had operations on both eyes.

Mark McGraw

Possibilities and Payoffs In Going Green

As a marketing catchphrase, "going green" has become unavoidable, but the efforts it seeks to promote are not just environmental. Sustainability has fiscal benefits, too. Consider both the environmental and budgetary benefits of implementing a fluid waste disposal system versus solidifying fluids and disposing of them in red bag waste. Or of opting for rigid instrument reprocessing containers over yards and yards of blue wrap. Or how much energy efficiency could lighten your facility's utility bills.

In many cases, doing the economical thing might actually serve as a motivating factor for doing right by the environment. "Going green goes beyond saving the environment," says an administrator in "Good To Be Green", Outpatient Surgery Magazine's look at the topic. "I really think it's more about saving money."

David Bernard

InstaPoll: Where Do Your Strongest Nurses Work?

As a surgical facility manager, one of your biggest challenges is assembling a top-notch team of nurses and putting them in positions to succeed. How do you deploy your nurses? Tell us in this week's InstaPoll where you assign your strongest nurses to work: in pre-op, the OR or recovery.

Last week we asked you tell us how long you've been in your current position. We were somewhat surprised to see that nearly three-fourths (72%) of respondents have been at the same job for more than 5 years. The results, based on 886 responses:

  • More than 10 years: 41%

  • 5 to 10 years: 31%

  • 2 to 5 years: 17%

  • 1 to 2 years: 8%

  • I just started not too long ago: 3%

    Dan O'Connor

  • News & Notes
  • System 1E software upgrade The FDA has granted Steris Corp. a 510(k) approval to make software modifications to new and existing System 1E sterilization devices, which replaced the company's older generation System 1. The FDA ordered facilities to stop using the SS1 in December 2009 after accusing Steris of making significant modifications to the unit without seeking additional clearance to do so.

  • Call to action on sharps safety A Consensus Statement and Call to Action endorsed by the International Healthcare Worker Safety Center at the University of Virginia and the American Nurses Association focuses on 5 areas for improvement in needlestick prevention efforts.

  • GI surgery safety checklist Aiming to support safe surgery and quality care in ASCs' gastro services, the American Society for Gastrointestinal Endoscopy, American College of Gastroenterology and American Gastroenterological Association have jointly developed a checklist covering perioperative procedure and common concerns. The 2-page checklist is available for free download on ASGE's website.

  • Bariatric accreditation programs unified The American College of Surgeons and the American Society for Metabolic and Bariatric Surgery have announced plans to combine their bariatric surgery center accreditation programs into 1 national accreditation standard. Effective April 1, any facility that has met the standards of either program will be considered accredited under the joint program.