For every technology, there's a downside—and for EHRs, one of the buzzed-about downsides was the supposed ease of upcoding: the practice of selecting the most remunerative code for a particular procedure. But a new study in Health Affairs—published by Julia Adler-Milstein of the University of Michigan and Dr. Ashish K. Jha, an internist with the Veterans Affairs Department and professor with the Harvard School of Public Health—casts doubt on that preconception.
The authors used a case-mix index to measure the weight of its codes and, thereby, the extent to which a hospital may be upcoding. The authors then matched early adopters of EHRs, from 2008 to 2012, to hospitals (up to three) that were similar in all other respects. The latter group served as a control.