Menus Subscribe Search

Cost Savings From Health IT: Priceless

• November 24, 2009 • 1:11 AM

The miracle berry’s astounding ability to turn the sour sweet makes it a party favorite, but its properties may help dieters and cancer patients, too.

Of all of the arguments at the heart of the U.S. health care debate this year, one stands out as particularly nonpartisan and uncontroversial: If we could just migrate everything doctors and hospitals do onto computers, the whole system would run more smoothly and, in turn, be cheaper.

A RAND Corporation study estimated the savings from electronic medical records would be about $77 billion a year. The Center for American Progress added the federal government would save $196 billion over the next decade. The Obama administration has made the argument — probably because of its consensus appeal — a focal point of its health care pitch going back to the 2008 campaign. The whole idea just seems, well, common sense.

Not to spoil a good holiday week (and a rare hiatus in the health care wrangling in Washington), but a new Harvard study suggests all of these claims are simply wrong. Health “information technology,” the research concluded, has yielded neither substantial efficiencies nor any real savings at the U.S. hospitals that today use various forms of it.

The results of the national survey of about 4,000 hospitals were published Friday online in the American Journal of Medicine. They reflect the reality that even health IT is intimately bound up in a system tied as much to profits as health outcomes. Most of the software currently on the market — and purchased by hospital administrators, not doctors — is designed to facilitate billing, not necessarily patient care.

The Harvard study was based on a survey of hospitals currently using health IT, while the other figures are based largely on mathematical projections and not analyses of existing data — data which even the Congressional Budget Office said before now existed in scant form. A link to the CBO assessment can be found here.

“In my everyday work with a computer system at my hospital, which is one of the widely distributed ones, I go through probably a couple hundred unnecessary mouse clicks a day that are there purely for billing purposes,” said David Himmelstein, a Harvard professor and one of the authors of the study, alongside Adam Wright and Steffie Woolhandler.

Whenever he sees a patient, for example, he must answer these questions: Did he have to use an interpreter? If so, was the interpretation done face-to-face or over the phone?

“That’s purely because the hospital can be reimbursed by some insurers a bit more if I have an interpreter,” he said.

In one sense, this software actually does the opposite of what many of us assume. Rather than help anyone save money, it helps maximize the hospital’s ability to collect money from patients and insurers.

Health IT could, in theory, improve the work of clinicians and the quality of patient care, allowing for benefits like faster access of lab results and better communication between referring doctors. But Himmelstein’s critique is twofold: The systems currently in existence aren’t prioritized to do that, and even if they were, the result wouldn’t include the windfall in savings we all expect.

When asked why so many of us assume this to be true when it’s not, Himmelstein deferred to this YouTube clip of a cheery 1961 promotional video touting the endless promise of electronic medical records:

We’ve been convinced, Himmelstein says, by a 40-year marketing campaign and our own wishful thinking.

“We wish that there were a quick, easy solution that didn’t actually involve any difficult political decisions for how we’re going to save money for health care and improve the quality of care,” he said. “That’s part of what would be lovely about computers – gee, we don’t have to do anything but install this machine and solve all these problems.”

It’s easy to imagine Himmelstein’s sobering study in the hands of red-faced Republicans on the floor of the Senate as it moves forward after Thanksgiving with the health care debate. See, the research seems to suggest, the Obama administration doesn’t know what it’s talking about.

Himmelstein and his colleagues are no strangers to academic cherry-picking on the Hill. They authored another report this year, linking 45,000 deaths a year in America to the lack of health care coverage, that made little-known Florida congressman Alan Grayson a C-Span star.

But if any politicians are wondering what the researchers think, Himmelstein and his fellow authors — members of Physicians for a National Health Program — believe that in the absence of a silver-bullet solution like health IT, Congress has to make a really politically difficult decision.

“They ought to start from scratch and do it right,” Himmelstein said.

Which means what exactly?

“A single-payer national health insurance system.”

Sign up for our free e-newsletter.

Are you on Facebook? Become our fan.

Follow us on Twitter.

Add our news to your site.

Emily Badger
Emily Badger is a freelance writer living in the Washington, D.C. area who has contributed to The New York Times, International Herald Tribune and The Christian Science Monitor. She previously covered college sports for the Orlando Sentinel and lived and reported in France.

More From Emily Badger

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

September 2 • 4:00 PM

Professors’ Pet Peeves

Ten things to avoid in your classrooms this year.


September 2 • 2:00 PM

Music Lessons Enhance Brain Function in Disadvantaged Kids

Children from poor neighborhoods in Los Angeles who took regular music lessons for two years were able to distinguish similar speech sounds faster than their peers.


September 2 • 12:00 PM

California Passes a Bill to Protect Workers in the Rapidly Growing Temp Staffing Industry

The bill will hold companies accountable for labor abuses by temp agencies and subcontractors they use.


September 2 • 10:00 AM

SWAT Pranks and SWAT Mistakes

The proliferation of risky police raids over the decades.


September 2 • 9:12 AM

Conference Call: The Graphic Novel


September 2 • 8:00 AM

Why We’re Not Holding State Legislators Accountable

The way we vote means that the political fortunes of state legislators hinge on events outside of their state and their control.


September 2 • 7:00 AM

When Men Who Abstain From Premarital Sex Get Married

Young men who take abstinence pledges have trouble adjusting to sexual norms when they become husbands.


September 2 • 6:00 AM

The Rise of Biblical Counseling

For millions of Christians, biblical counselors have replaced psychologists. Some think it’s time to reverse course.


September 2 • 5:12 AM

No Innovation Without Migration

People bring their ideas with them when they move from place to place.


September 2 • 4:00 AM

Why Middle School Doesn’t Have to Suck

Some people suspect the troubles of middle school are a matter of age. Middle schoolers, they think, are simply too moody, pimply, and cliquish to be easily educable. But these five studies might convince you otherwise.


September 2 • 3:13 AM

Coming Soon: When Robots Lie


September 2 • 2:00 AM

Introducing the New Issue of ‘Pacific Standard’

The science of self-control, the rise of biblical counseling, why middle school doesn’t have to suck, and more in our September/October 2014 print issue.


September 1 • 1:00 PM

Television and Overeating: What We Watch Matters

New research finds fast-moving programming leads to mindless overeating.



September 1 • 6:00 AM

Why Someone Named Monty Iceman Sold Doogie Howser’s Estate

How unusual names, under certain circumstances, can lead to success.



August 29 • 4:00 PM

The Hidden Costs of Tobacco Debt

Even when taxpayers aren’t explicitly on the hook, tobacco bonds can cost states and local governments money. Here’s how.


August 29 • 2:00 PM

Why Don’t Men and Women Wear the Same Gender-Neutral Bathing Suits?

They used to in the 1920s.


August 29 • 11:48 AM

Your Brain Decides Whether to Trust Someone in Milliseconds

We can determine trustworthiness even when we’re only subliminally aware of the other person.


August 29 • 10:00 AM

True Darwinism Is All About Chance

Though the rich sometimes forget, Darwin knew that nature frequently rolls the dice.


August 29 • 8:00 AM

Why Our Molecular Make-Up Can’t Explain Who We Are

Our genes only tell a portion of the story.


August 29 • 6:00 AM

Strange Situations: Attachment Theory and Sexual Assault on College Campuses

When college women leave home, does attachment behavior make them more vulnerable to campus rape?


August 29 • 4:00 AM

Forgive Your Philandering Partner—and Pay the Price

New research finds people who forgive an unfaithful romantic partner are considered weaker and less competent than those who ended the relationship.


August 28 • 4:00 PM

Some Natural-Looking Zoo Exhibits May Be Even Worse Than the Old Concrete Ones

They’re often designed for you, the paying visitor, and not the animals who have to inhabit them.


August 28 • 2:00 PM

What I Learned From Debating Science With Trolls

“Don’t feed the trolls” is sound advice, but occasionally ignoring it can lead to rewards.


Follow us


Subscribe Now

When Men Who Abstain From Premarital Sex Get Married

Young men who take abstinence pledges have trouble adjusting to sexual norms when they become husbands.

Your Brain Decides Whether to Trust Someone in Milliseconds

We can determine trustworthiness even when we’re only subliminally aware of the other person.

Young, Undocumented, and Invisible

While young migrant workers struggle under poor working conditions, U.S. policy has done little to help.

Education, Interrupted

When it comes to educational access, young Syrian refugees are becoming a “lost generation.”

No, Smartphone-Loss Anxiety Disorder Isn’t Real

But people are anxious about losing their phones, even if they don’t do much to protect them.

The Big One

One third of the United States federal budget for fighting wildfires goes toward one percent of such fires. September/October 2014 big-one-fires-final

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.