Federal officials are looking at ways to prevent patients from being repeatedly given the same lab test because doctors did not know they had already done the exam, Centers for Medicare and Medicaid Services, or CMS, administrator Seema Verma said in a statement April 3.
Verma's comments shed some more light on the issues CMS is looking at as part of an initiative, that was announced in March, to make it easier for patients to get electronic versions of their medical records.
Having access to their medical records would make patients more "empowered" by giving them "all of the information they need to make the best decisions about their care. This starts by ensuring patients have access to their medical records in an easy-to-understand format, and that is portable from doctor to doctor, provider to provider," Verma said.
Though short on specifics, she said in the statement that the CMS was also working to streamline the information required on electronic health records to reduce the administrative burden on medical providers and give them more time to attend to patients.
She had made similar comments at a March 22 roundtable discussion with healthcare reporters where she said the agency was working to make sure electronic records are compatible with each other.
But in a new wrinkle, Verma's April 3 statement said: "We are also studying the incidence of repeat testing that occurs due to providers not sharing test results electronically. Repeat testing leads to increased costs and patient inconvenience [or even patient harm], so the agency is analyzing ways to reduce the frequency of repeat testing as we move towards interoperable systems."
The issue, however, is complicated.
A 2010 study in the Journal of the American Medical Informatics Association, or Jamia, examined 85 patients transferred between Boston Children's Hospital and Brigham and Women's Hospital, which have separate electronic health record systems, and found 32% had a duplicative test within 12 hours of arriving at the second facility. Twenty percent of the patients had a duplicative test that was not medically indicated, the study found.
While previous studies found that inaccessibility of paper records led to duplicate testing when patients were transferred between care facilities, this study suggested that "incomplete electronic record transfer among incompatible electronic medical record systems" could also create potentially costly duplicate testing behaviors, the Jamia study said.
A 2015 study by researchers at New York Hospital Medical Center of Queens and the Weill Cornell Medicine in the journal Cardiology Research and Practice noted that a 2005 report by nonprofit global policy think tank RAND Corporation estimated the widespread implementation of electronic health records could save the healthcare system over $80 billion annually.
But the New York researchers found the introduction of electronic medical records actually led to an increase in repeat transthoracic echocardiograms at the Queens hospital. The researchers theorized that as the electronic records system has an option to order an echocardiogram, doctors might believe its easier to order a new test than go through the old one.