In a recent full-page newspaper advertisement, IBM touted massive medical savings through computerization. It's a promise they've made before, starting with a report issued in 1961. If only these promises were true.
For 50 years, we've been told that computers would give doctors ready access to past tests and diagnoses, eliminating duplicate tests that are unnecessary and costly. But it turns out the reverse is true.
Our study published this month examined 28,741 patient visits to 1,187 physicians. We found that when doctors can view X-ray results online, they actually order 40 percent to 70 percent more X-rays, including costly CT scans and MRIs. And the same holds true for blood tests.
Even the most wired doctors - those with full electronic medical records and those in hospital-owned practices where old test results are most likely to be available electronically - showed no signs of moderating their test ordering.
Sparing doctors the inconvenience of tracking down results seems to lead to more testing, not less.
Computer vendors' promises of cost savings by eliminating paperwork have also flopped. In a previous study of 3,800 hospitals, we found that computerization actually increased hospitals' administrative costs.
Make no mistake: we support clinical computing. It's an essential tool for improving medical care. One of us directed clinical computing at a Harvard hospital for more than a decade. And a handful of hospitals have developed computer systems that have improved care and may even cut costs.
