EMR Benefits and Return on Investment Categories

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EMRs have many benefits and return on investments

Investment Flexibility:

How much investment is available over a certain period of time? For example if a hospital considering to install a nursing system may conduct a pre- and post-implementation analysis of investment including maintenance cost, operating cost, nursing time and activities, determining the exact time spent on each patient activity.

Management Risk Disposition

Willingness to invest in experimental efforts.

Provide users with real time knowledge

Reducing non-clinical time

Increase patient doctor time:

Investment Motivation:

To reduce cost, position for capitation/managed care, and gain market share.

To enable providers to take advantage of financial incentives under the HITECH Act related to "Meaningful Use". https://www.cms.gov/EHRIncentivePrograms/01_Overview.asp#TopOfPage

--Sfjafari 22:21, 10 September 2011 (CDT)

--Sfjafari 22:29, 10 September 2011 (CDT)

Administrative and management benefits

  • Overall transparency among the processes
  • Improved communication among the clinical to clinical and clinical to administrative staff
  • Reduction in drug and radiology usage in the outpatient setting

Return on Investment (ROI)

Quality Care

One could approach the ROI from the perspective of the Institute of Medicine Report, Crossing the Quality Chasm

  1. Safe: Reducing adverse drug events, inappropriate testing
  2. Effective: Reducing drug costs through appropriate prescribing
  3. Efficient: Reducing drug, laborotory, or radiologic utilization
  4. Timely: Reducing wait times
  5. Patient-centered: Reducing length-of-stay while hospitalized
  6. Equitable: Provides data to demonstrate equal delivery

Quantitative Benefits:

These are financial benefits that are clearly measurable and are attributable to the use of a particular technology. E.g., the use of EMR technology to submit claims has resulted in widely quantified cost savings for provider and payer organizations.

Qualitative Benefits:

The EMR will improve patient care by reducing medication error and wait time. Clinical processes will be standardized and there will be less variation in clinical care provided at place from another. Records would be easily shared among the providers, which will reduce the process time and over all improve the disease management.It will also improve the communication among the care providers and the administrative staff and administrative activities.

These are directly and indirectly attributed to the technology but are more difficult to quantify. E.g., implementation of a clinical nursing system may lead to increased case in recruiting efforts, better nurse retention, more rapid access to clinical nursing data, and decreased charting time. Quantification and measurement – of benefits usually is difficult because of the task complexity of the nursing function.

Strategic Benefits:

These offer substantial benefits to the organization, but at some future date. E.g., investments in networking and telecommunications offer significant future strategic benefits, positioning organizations to utilize enterprise-wide patient indexing and EMR or distributed case management technologies as they emerge.

--Sfjafari 22:29, 10 September 2011 (CDT)

Costs

The Medical Group Management Association (MGMA) says the average cost of an EMR per physician is $33,000. (http://www.physicianspractice.com/display/article/1462168/1591117)

Software License:: EMR license prices can easily range from $1,000 – $25,000. The average license for a FULL/TRUE EMR usually starts at $10,000, while a light/entry EMR usually starts at around $1,000, and these costs tend to recur. (http://www.phyaura.com/resources-2/open_source/)

Implementation: Implementation costs are usually billed hourly at a rate of $75-$150 per hour. Average implementation time per provider is 35 hours. Where 10 hours are used for customization, 25 hours for training and 10 hours for computer/network setup. This becomes exponentially lower as more physicians are added. (http://www.emrexperts.com/emr-roi/index.php)

Hardware: Network hardware and configuration, number and type of servers/workstations, hand-held devices, etc. is driven by the vendor's requirements and recommendations, as well as your organization's needs. Costs depend on quantity of equipment purchased or leased. For example, a tablet PC could cost $2,000, a workstation $1,500 and a server $5,000. (http://www.emrapproved.com/emr-hardware.php)

Support & Maintenance: Ongoing support costs will be incurred from both an annual support contract with the software vendor for updates and technical support and the increased need of hardware/network support through a local IT representative. (http://www.emrexperts.com/emr-roi/index.php)

Research

Barriers of EMR Implementation

  • In order for an EMR to be truly successful, proper and timely training must be administered to all who will interact with the system.
  • Conflicting research findings on the cost and efficiency benefits of EMR implementations will make it difficult, if not impossible, for administration staff to be confident in choosing an EMR for their facility. Until there is adequate research on multitudes of EMR systems that shows causal relationships between facility characteristics and the related EMR components there will not be a sufficient method of EMR selection and implantation.
  • If it is true that implementations of EMRs cause a decrease in efficiency and an increase in quality of medical care then further research must take both of these repercussions into account and determine if there is an overall net benefit of EMR implementation.
  • The variability of results of similar studies on the monetary and efficiency benefits of EHRs indicates that there is no single approach to EMR implementation that will fit all settings. Variables such as hospital size, setting, specialty, prior computer integration, etc will determine the effectiveness of an EMR dramatically and must be considered in all cases.

EMR Cost Categories


References

Committee on Quality of Health Care in America, Institute of Medicine. "Front Matter." Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press, 2001. Full text

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