Support of quality and business goals by an ambulatory automated medical record system in Kaiser Permanente of Ohio

• HIT Description: Ambulatory electronic medical records More info...
  
• Purpose of Study: Describe the implementation and value of EMR in Kaiser
  
• Years of study: 1992-1997
  
• Study Design: Time Series
  
• Outcomes: Impact on health care effectivness/quality, Impact on efficiency, utilization, costs
  

• Settings: A large Health Maintenance Organization Ð Kaiser-Permanente of Ohio
• Evaluation Method: Qualitative and quantitative appraisal of the EMR system including a ballpark prediction of its annual savings and expenses.
• Description: Automated medical record which collected and presented data at the time of an encounter. The system also generates physician reminders for guideline compliance and patient reminders for preventive services.
• Interoperability: Linked to digital data on the mainframe, such as lab results, radiology reports, emergency department notes, and hospital discharge summaries.
• Implementation: For implementation strategy and financial context please see Finding value in EMRs in Health Management Technology, 1997.
• System Penetration: The EMR system has been fully implemented in 13 ambulatory care locations in Cleveland and surrounding communities and accessed for every patient encounter. It has been incorporated into the routine care process.
• Cost of HIT systems: The cost of system development was reported elsewhere. Annual expenses include $600,000 for personnel, $200,000 for printing, $150,000 for network expenses, $200,000 for memory, and $80,000 for license renewals, totaling $1,230,000/year.
• Quality of Care and Patient Safety Outcome: Examples given included improved care in CAD, CHF, diabetes mellitus, hypertension, asthma, and preventive health care.
• Changes in efficiency and productivity: Expected savings include $2,800,000 for reduction of medical record room and support staff, $500,000 for elimination of clinical forms, and $400,000 for automatic collection of billing data, totaling $3,700,000/year.�