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Price Tags On EMRs

Pundits cite the cost of healthcare as one of the leading issues facing our country. Every year, an increasingly larger fraction of our GDP goes towards labs, images, and medications which are, often times, ordered for no meaningful purpose. Some will argue that physicians over-order tests for the sake of defensive medicine (“If I order everything, chances are that I won’t miss something worthy of a lawsuit.”) But that’s a different discussion all together.

stethoscope-dollar
Credit: healthcaretechnologyonline.com
As a resident physician training with a cost-effective mindset, I think there’s a simple solution which could go a LONG way – have the major EMR systems like EPIC and Meditech list prices next to every lab, medication, procedure, and imaging modality. It doesn’t have to be a massive, triple red-flag, obstructive piece of text either. If I wanted to order a brain MRI “just to check something”, it would make me think twice if I saw:

"MRI Brain w w/o contrast ($5315.78)"

Do I really want to spend over $5,000 plus labor time to check something which may not even alter the management course? And what if waiting for that MRI makes the patient stay an extra day receiving telemetry-level care? Now extrapolate that to the countless labs and other “diagnostic” things we do. That’s a lot of money.

Even ordering morning labs has become arduous task of redundancy. There is no reason every patient should have a complete blood count (CBC) and basic metabolic profile (BMP) done every… single… day. Maybe we’ll think twice about signing orders when we’re prompted with routine AM labs costing hundreds of dollars?

It seems like a pretty straightforward addendum to the EMR framework, so I’d love to read your opinions on the topic! Maybe some programs have already implemented a “price tag” system?

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 3 comments

  1. That will help but not much. Most of care is provided to people who pay very little or nothing like Medicaid, Veterans, retired military and in my experience they will ask all care at all cost to others, even if MRI cost a million dollar. Even Medicare patient pay very little specially who use it most.
    Bottom like is only in a fee base and need base care cost of healthcare will be contained. Obama care will make it worse as there is now no limit how much one is entitled for care and insurance will be provided by federal government.
    It is not too much to ask to pay more for more care . I know it is not politically correct

  2. totally agree Rishi. I don’t think I’ve ever been told the cost of anything in the medical field unless I asked (and even then most of the time nobody could tell me the answer).

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