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Seeing Lab Costs in an EHR May Save Your Practice Money


A study of 215 primary-care physicians at Atrius Health in Massachusetts reveals how EHRs can serve as a key tool to help control rising costs.

If your practice is trying to curb costs, perhaps physicians should use an EHR to actually look at them.

According to a new study from Atrius Health, a not-for-profit alliance of six community-based medical groups and a home health care and hospice agency in Massachusetts, if physicians view the costs of laboratory tests in real time, it affects their utilization of these tests. The study, which will be highlighted in an upcoming Journal of General Internal Medicine edition, used data from 215 primary care physicians at Atrius Health to demonstrate that costs viewed in an EHR serve as a key tool to help control rising healthcare costs.

For the study, physicians were split into two groups: an "intervention" group and a control group. Doctors in the intervention group received real-time information on laboratory costs for 27 individual tests when they placed their electronic orders, while the control group did not. Changes in the monthly laboratory ordering rate between the intervention and control groups were compared for 12 months before and six months after the intervention started. Six months after the intervention, all physicians taking part in the study were also asked to assess their attitudes regarding costs and cost displays.

According to researchers, physicians who viewed test costs electronically in real time for 27 different tests ordered fewer high- and low-cost range tests. The conclusion: Cost awareness can make a big difference in a practice's bottom line. "Doctors tell us all the time that they don't have a sense of what tests cost so our primary goal in showing these costs to providers was to educate them," Thomas D. Sequist, an internal medicine physician with Atrius Health and senior author on the study, told Physicians Practice. "We were trying to give them as much information as possible to help them practice value-based medicine and educate their patients as well. Our study demonstrates that EHRs can serve as a tool to promote cost transparency, educate physicians, and reduce the use of potentially unnecessary laboratory tests. With further research and testing, these findings show tangible results that you can receive quality care at lower costs."

Physicians were also receptive to the real-time information - 81 percent reporting that the exercise increased their knowledge regarding the costs of care. The study is important for other reasons. Healthcare costs continue to go up, and physicians control more than 80 percent of those costs, said Sequist.

"We talk about cost transparency for consumers, but it is lacking for physicians," said Sequist. "Physicians care about their patients and know that costs are one of their biggest concerns, and a factor in non-compliance. By having that information up front and in real time, physicians can have meaningful conversations with their patients about treatment plans."

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