Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. The adoption of interoperable EMR systems could produce efficiency and safety savings of $142-$371 billion

• HIT Description: National implementation of EHR More info...
  
• Purpose of Study: To estimate the potential financial and health benefits associated with broad use of interoperable EHRs
  
• Years of study: Several secondary data sources were utilized. Medical Expenditure Panel Survey (MEPS) data from 1999. American Hospital Association Hospital Survey from 2000. 2000 National Ambula-ry Medical Care Survey (NAMCS). Data were also taken from the Dornfest Data Base (proprietary data base of health information technology use), however years for which data were taken from this source were not specified.
  
• Study Design: Statistical Modeling, including Monte Carlo Simulation Statistical Modeling, including Monte Carlo Simulation
  
• Outcomes: Estimates of efficiency savings, costs of national EHR adoption, potential safety benefits, potential health benefits
  

• Settings: Model assumes widespread inpatient and outpatient EHR use on a nationwide level
• Intervention: Hypothetical EHRs
• Description: A model evaluating the impact of widespread national adoption of interoperable EHRs
• Interoperability: Model assumes full machine level interoperability between EHR systems.
• Implementation: Model assumes that 90% of all U.S. hospitals and outpatient practices will have adopted EHRs by the end of a 15 year period.
• System Penetration: Model assumes 90% adoption of EHRs nationwide.
• Barriers: Barriers were hypothesized to be lack of data standards, costs, uncertain financial returns, and disruptive effects on practices, and a misalignment of investment costs and financial benefits.
• Cost of HIT systems: Simulation methods were used to estimate the cumulative costs for 90% of hospitals to adopt EHR systems as $98 billion (assuming 20% of current hospitals have already adopted EHRs) with a yearly average costs of $6.5 billion over a 15 year adoption period. Estimates for 90% of outpatient practices to adopt EHRs was estimated was $17.2 billion (nearly equally split between initial and maintenance costs). Average costs during the 15 year adoption period were estimated to be $1.1 billion per year.
• Cost of Implementation: Model assumes that after implementation physician productivity will fall 15% for 3 months before returning to baseline levels; Assume maintenance costs to be 20% of initial acquisition/implementation costs
• Quality of Care and Patient Safety Outcome: Health benefits were estimated to come from improved disease management for chronic conditions, improved safety and preventive care.
• Changes in healthcare costs: Cost savings from improved efficiency assuming 90% nationwide EHR adoption were estimated to be $77 billion/ year at steady state. Overall cost savings associated with widespread EHR use were estimated to be primarily dependent on productivity gains; Productivity gains were estimated through comparisons with other industries. Costs savings to the U.S. healthcare system as a whole were estimated to be $81 billion if pro