Assessing the cost of electronic health records: a review of cost indicators.

We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

[1]  Wilson W. Odero,et al.  The Mosoriot medical record system: design and initial implementation of an outpatient electronic record system in rural Kenya , 2000, Int. J. Medical Informatics.

[2]  Nir Menachemi,et al.  Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient Safety Technologies , 2006, Journal of Medical Systems.

[3]  Johan van der Lei,et al.  Cost consequences of implementing an electronic decision support system for ordering laboratory tests in primary care: evidence from a controlled prospective study in the Netherlands. , 2007, Clinical chemistry.

[4]  Steven John Simon,et al.  An examination of the financial feasibility of Electronic Medical Records (EMRs): a case study of tangible and intangible benefits , 2006, Int. J. Electron. Heal..

[5]  Terry S. Field,et al.  Application of Information Technology: Costs Associated with Developing and Implementing a Computerized Clinical Decision Support System for Medication Dosing for Patients with Renal Insufficiency in the Long-term Care Setting , 2008, J. Am. Medical Informatics Assoc..

[6]  Michael H Zaroukian,et al.  Benefiting from ambulatory EHR implementation: solidarity, six sigma, and willingness to strive. , 2006, Journal of healthcare information management : JHIM.

[7]  Hamish S F Fraser,et al.  Development, implementation and preliminary study of a PDA-based tuberculosis result collection system. , 2006, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[8]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[9]  J. Øvretveit,et al.  Improving quality through effective implementation of information technology in healthcare. , 2007, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[10]  Marta Marsilio,et al.  A methodological and operative framework for the evaluation of an e-health project. , 2008, The International journal of health planning and management.

[11]  N. Fleming,et al.  Finding the ROI in EMRs. , 2008, Healthcare financial management : journal of the Healthcare Financial Management Association.

[12]  Paula Asikainen,et al.  Usefulness of a Regional Health Care Information System in primary care: A case study , 2008, Comput. Methods Programs Biomed..

[13]  Hamish S. F. Fraser,et al.  Evaluations of the Impact of eHealth Technologies in Developing Countries: A Systematic Review , 2008 .

[14]  Tricia L Erstad,et al.  Analyzing computer based patient records: a review of literature. , 2003, Journal of healthcare information management : JHIM.

[15]  Amy K. Yarbrough,et al.  Technology Acceptance among Physicians , 2007, Medical care research and review : MCRR.

[16]  Monica Hogan,et al.  Electronic health record implementation in community nursing homes. , 2007, Journal of the American Medical Directors Association.

[17]  M. Simonian.  The electronic medical record. , 2007, Pediatrics in review.

[18]  Sharon S. Choi,et al.  Implementing electronic medical record systems in developing countries. , 2005, Informatics in primary care.

[19]  E. Keeler,et al.  Costs and benefits of health information technology. , 2006, Evidence report/technology assessment.

[20]  Anne F. Kittler,et al.  A cost-benefit analysis of electronic medical records in primary care. , 2003, The American journal of medicine.

[21]  Stephen H. Cohen,et al.  A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center. , 2007, Journal of the American College of Surgeons.

[22]  Claus Duedal Pedersen,et al.  The cost benefit of electronic patient referrals in Denmark: summary report. , 2004, Studies in health technology and informatics.

[23]  S. Shortell,et al.  Implementation of electronic medical records in hospitals: two case studies. , 2007, Health policy.

[24]  Hamish S. F. Fraser,et al.  Evaluating the impact and costs of deploying an electronic medical record system to support TB treatment in Peru , 2006, AMIA.

[25]  Ricardo João Cruz Correia,et al.  Integration of hospital data using agent technologies - A case study , 2005, AI Commun..

[26]  J. Sidorov.  It Ain't Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs. , 2006, Health affairs.

[27]  J. Cooper,et al.  Organization, management, implementation and value of ehr implementation in a solo pediatric practice. , 2004, Journal of healthcare information management : JHIM.

[28]  J. Donnelly,et al.  Keeping it real--building an ROI model for an ambulatory EMR initiative that the physician practices espouse. , 2006, Journal of healthcare information management : JHIM.

[29]  Christopher E. West,et al.  The value of electronic health records in community health centers: policy implications. , 2007, Health affairs.

[30]  J. Wei.  Productivity and Cost Implications of Implementing Electronic Medical Records Into an Ambulatory Surgical Subspecialty Clinic , 2008 .

[31]  K. Yamauchi,et al.  Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey , 2004, Medical informatics and the Internet in medicine.

[32]  Wilson W. Odero,et al.  Application of Information Technology: Installing and Implementing a Computer-based Patient Record System in Sub-Saharan Africa: The Mosoriot Medical Record System , 2003, J. Am. Medical Informatics Assoc..

[33]  R. Baron,et al.  Electronic Health Records: Just around the Corner? Or over the Cliff? , 2005, Annals of Internal Medicine.

[34]  Christopher E. West,et al.  The value of electronic health records in solo or small group practices. , 2005, Health affairs.

[35]  S. Huff,et al.  Building a Comprehensive Clinical Information System from Components , 2003, Methods of Information in Medicine.