New Study Contradicts ‘Conclusion’ about Lab Studies

April 4, 2012
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In the classic Woody Allen movie, “Annie Hall,” there’s a scene in which Woody and Diane Keaton are standing in a line to see a movie, and some guy behind them starts spouting off about a film director to impress his girl friend.

In the classic Woody Allen movie, “Annie Hall,” there’s a scene in which Woody and Diane Keaton are standing in a line to see a movie, and some guy behind them starts spouting off about a film director to impress his girl friend. The guy’s opinions are driving Woody nuts.  Then the guy brings up Marshall McLuhan and the media.  Woody steps forward and asks the camera, “What do you do when you get stuck in a movie line with a guy like this behind you?” The guy comes over and starts arguing his case to the camera too.  When Woody tells him he knows nothing about McLuhan, the guy says he took a class at Columbia University, titled “TV, Media and Culture.” Woody then goes over and brings McLuhan on camera (he is conveniently there at the movie theater and has overheard the guy’s analysis). McLuhan tells the guy, “You know nothing about my work.” Woody ends the scene, saying “If only life was really like this!”

When you read something that you know can’t be right, but it has the support of data to prove its “validity,” that’s when you wish for a “Marshall McLuhan moment.”  Thankfully, a new study in the Archives of Internal Medicine (“Bridging the Chasm of Health Information Exchange on Volume of Laboratory Testing“) provides it in regards to a published study earlier this month.  In the earlier study, in Health Affairs (“Docs more likely to order additional imaging tests with electronic access“), researchers determined that physicians with access to the results of a patient’s previous imaging and blood tests in an electronic medical record ordered more tests than those who did not have an EHR.  I took the study at its word and theorized that if doctors are ordering another study, they’re doing it to benefit the patient.  But my gut reaction to the study’s conclusion was how can this be right!

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Now we find the new Archives study is based on the medical records of more than 117,000 patients treated in the outpatient departments of Boston-based Brigham & Women’s and Mass General Hospitals between 1999 and 2004.  Overall, the number of tests ordered for each patient fell from an average of 7 to four after a health information exchange (HIE) was instituted between the two hospitals.  The number ordered for those who had prior tests in their EHR fell by 49%.  That means physicians cut the number of redundant test orders in half.

As I noted in an earlier post, EMDTransfer – a company GlobalMed acquired in late 2011 – helps reduce redundant CT Scans for trauma patients, especially those presenting at hospitals where specialists, like neurologists or neurosurgeons, are not available.  The same CT Scan performed at the smaller hospital can now be made available to the specialist at a larger urban hospital via the cloud.  This prevents a redundant study at the larger hospital if the patient is transferred there, and also reduces the exposure to radiation for the patient.

By the way, that classic Woody Allen scene is available here on YouTube.