The authors of the recent Health Affairs study linking increased test ordering to electronic access to results have responded to a blog post by Farzad Mostashari, MD, national coordinator for health IT.
Led by Danny McCormick, MD, the authors stated that "some of the assertions in his blog post are mistaken. Some take us to task for claims we never made, or for studying only some of the myriad issues relevant to medical computing. And many reflect wishful thinking regarding health IT, an acceptance of deeply flawed evidence of its benefit and skepticism about solid data that leads to unwelcome conclusions."
McCormick stressed the need for "fruitful dialogue" as a result of Mostashari’s critique of his study.
He called Mostashari to task for contradicting numerous studies that have quantified expected savings due to health IT, criticizing the authors for analyzing the relationship of EHRs to test ordering, asserting that the study's 2008 data are passe and incorrectly stating that the analysis did not take into account patients’ severity of illness, physicians’ level of training and the nature of physicians’ financial arrangements.
McCormick also wrote that the literature review Mostashari cited in his blog posting is "interesting," but does not contradict his findings. Mostashari's agency is disbursing $19 billion in federal funds to stimulate the adoption of the inadequately evaluated technology, he said, although "no drug or new medical device could pass FDA review on such thin evidence as we have on health IT."
McCormick wrote, "We hope that some day his predicted savings can be achieved." However, he also said Mostashari's "health policy 'flavor-of-the-month' remains wholly unproven."