DISCLAIMER
The studies referenced here were reported in peer-reviewed publications as systematic reviews, hypothesis tests, or predictive analyses. Although the results are valid for the institutions they represent, they may not be valid for other organizations with different technical capacities, project management expertise, organizational culture, or human and economic resources - all of which may affect cost. In addition, these studies may not contain the full technical details of how health information technology was implemented or how it operates. Thus, these results are best used as general guidelines for determining costs and benefits rather than as absolutes, because they may not hold true for all organizations. Please refer to Chapter 4 of "Costs and Benefits of Health Information Technology," AHRQ Publication No. 06-E006, for additional information on the limitations and conclusions of the studies included in the evidence report.
- I am in a four-person practice. What will the cost of an electronic medical record (EMR) implementation be for me?
- We are a small practice being asked to participate in a regional health information exchange. What are the pros and cons of doing this? What workflow and productivity changes can we expect?
- I want to implement computerized physician order entry (CPOE) in my hospital. What is the cost? What are the caveats?
- We are a small practice interested in improving care effectiveness by implementing an electronic health record (EHR) system. What does the research tell us on whether and how we can succeed?
- We've been asked to implement a computerized physician order entry (CPOE) CPOE system as part of a patient safety initiative. What can we really expect in terms of health benefits from CPOE?
Question 2. We are a small practice being asked to participate in a regional health information exchange. What are the pros and cons of doing this? What workflow and productivity changes can we expect?
Checking Data Exchange and all the boxes under cost/benefits outcomes we get the following:
NOTE: Below is an example screenshot of the search criteria you can use. Perform a search on the database.
The second article describes the cost of implementing a health information exchange. The summary is presented below. Estimated cost is $20,000 for software and $15,000 for interfaces per facility.
- Settings: N/A
- Evaluation Method: Mixed methods were used to define the models and estimate costs. An expert panel defined a functional model for a national health information network. The panel achieved consensus through a modified Delphi method. Estimates for costs were based on data taken from the Santa Barbara County Data Exchange, a regional network designed to exchange health data within Santa Barbara County, CA. Secondary data were taken from the 2000 U.S. Census Bureau and the National Center Health Statistics.
- Description: The model delineates a national health information network that is "achievable and desirable" in five years rather than an "ideal infrastructure." The projects expert panel selected the following functional domains to be critical to a national health information network: inpatient/ outpatient results viewing, Electronic Health Records, computerized provider order entry, electronic claims submission, electronic eligibility verification, secure electronic patient communication, and electronic prescriptions.
- Interoperability: The model assumes a brokered peer-to-peer architecture in which data were exchanged over the internet. Interoperability in the model is supported through software interfaces being implemented to allow different Health IT systems to exchange data.
- Barriers: Costs, complexity of integration of information through software interfaces.
- Costs: Total costs to achieve a national health information network in five years were estimated to be $156 billion dollars in capital costs and $48 billion per year in operating costs.
- Cost of Health IT systems: The total cost to achieve functionality of a model network in five years was estimated to be $103 billion in capital costs. The total costs to construct a brokered peer-to-peer communication network was estimated to be $53 billion in capital costs.
- Cost of Implementation: The model used several system cost estimates. Based on cost data from the Santa Barbara County Data Exchange ($35,000-$55,000 per facility) authors estimated software costs for data exchange to be $20,000 per facility as software becomes standardized and nationally produced. The authors estimated costs to create software interfaces needed to exchange data as $15,000 per system for an easy integration (20% of cases), $45,000 per system for a moderately difficult integration (30% of cases) and $90,000 per system for a difficult integration (50% of cases).
- Long-term Cost: Annual yearly operating costs were estimated to be $27 billion per year to maintain system functionality and $21 billion per year to maintain the brokered peer-to-peer communication network.