Difference between revisions of "EMR Benefits and Return on Investment Categories"

From Clinfowiki
Jump to: navigation, search
(→‎Operational)
(→‎Operational)
Line 129: Line 129:
  
 
=== Operational ===
 
=== Operational ===
−
 
−
* Integrated communication and reporting support. EMR can facilitate the efficient creation and transmission of reports that relate to health care operations such as billing and charge information. Coiera, E (2003) Guide to Health Informatics (2nd Edition), Arnold Publishers Shortliffe, EH (ed) (2006) Biomedical Informatics (3rd Edition), Springer. pg. 119.
 
−
 
−
* ''Data recovery becomes more manageable using a digital system versus a paper system''.--[[User:Kjbracey|Kjbracey]] 15:10, 23 January 2011 (CST)  Backups can be maintained for an EMR where as there are no disaster options for paper based systems.
 
−
 
−
* Automation of billing charges are typically included.  This reduces error in submitting codes to insurance companies.
 
−
 
−
* With anytime, anywhere access to their own EMR, patients can edit their medical history from the comfort of their home, and whenever they have time. Quickly editing a medical history in a waiting room is too error-prone. Additionally, it needs to be created only one time and could easily be corrected.
 
−
 
−
* Patient information cannot get lost or become inaccessible. This may happen with conventional records, for example when a practice is closed, or bad materials were used for paper or film material. The loss of electronic data is less probable due to highly evolved techniques for secure data storage.
 
−
 
−
* An EMR is almost essential in a telehealth-like setting, where a practitioner would like to ask a colleague for advice about a specific case. Through an EMR, the other side could easily access all the patient information. Besides saving time, efficiency is improved since the other side gets all information - or just part of it for privacy protection - and can decide what information is most relevant for the specific case.
 
−
 
−
* The use of a CPOE system in an ICU setting can cut down on errors [Potts AL, Barr FE, Gregory DF, Wright L, Patel NR. Computerized physician order entry and medication errors in a pediatric critical care unit. Pediatrics. 2004;113 :59 –63]
 
−
 
−
* The use of CPOE systems can improve the turnaround time of laboratory and radiology test results. [Thompson, Willie B, Dodek PM, Norena M, Dodek, Jordana BSc. Computerized physician order entry of diagnostic tests in an intensive care unit is associated with improved timeliness of service. Crit Care Med. 2004;32 :1306 –1309]
 
−
 
−
* Studies on "multifunctional systems" of HIT,  found evidence that implementing a multifunctional EHR system could increase the delivery of care that would adhere to guidelines and protocols, enhance the capacity of the providers of health care to perform surveillance and monitoring for disease conditions and care delivery, reduce rates of medication errors, and decrease utilization of care.  [B, Wang J, Wu S, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med 2006;144:742-752.]
 
−
 
−
*  Increased enrollment on clinical trials by using CDS to identify eligible patients.  Ref:  Embi PJ, Jain A, Clark J, Harris CM.  Development of an electronic health record-based Clinical Trial Alert system to enhance recruitment at the point of care.  AMIA Annual Symposium Proceedings, 2005:  231-5.
 
−
 
−
*  The ability to support patient mobility.  When a patient moves, is on vacation, or simply seeing a specialist; it is currently very difficult to transfer the Medical Records between hospitals.  With paper the records need to be pulled, faxed, and sent.  Then they need to be retrieved, processed, and then read.  With Integrated EMR, these steps can occur instantly.
 
−
 
−
*  Support of Bio-Surveillance.  We live in a time when man made (terrorists) and natural (epidemics) are all around us.  The advantage of the EMR is to eventually automatically, track outbreaks and health issues across regions, the country, or the world.  This will enable rapid detection and prevention of wide-spread out break.  The H1N1 outbreak is a prime example of how even a day or a few more hours of advanced notice could have helped contain the spread. 
 
−
 
−
*  Re-purposing of data.  There is a push these days to do more with less.  Access to a hospital's patients data enables retrospective studies and data mining.  It is a ready and accessible source (assuming proper anonymity can be obtained when required).  Instead of spending millions of dollars to track how infusions affect patient outcome in the ER, that data could be mined from decades of patient information.
 
−
 
−
*  Helps in better adapting to HIPAA standards. HIPAA now requires stricter control over patients data, with better audit in general. EMR are better equipped to provide the combination of security from unauthorized access and the ease of access for authorized users. Moreover, an EMR is better suited to adapt to changes that might be enforced in the future.
 
−
 
−
*  Among the problems commonly faced in all clinical settings, is the problem of conflicting prescriptions. The inability of physician to account for other prescriptions by other physicians even within the same hospital leads to over-medicating, or conflicting medications.
 
−
 
−
*  Better supervision from physicians in charge. Within academic hospital, physicians may find it impossible to maintain a high standard of care along with all the responsibilities of teaching and supervising medical students. Physicians may find it much easier to follow students' notes across all the different records to grade and suggest any changes.
 
  
 
*  Facilitates the communication of patients' data and needs among different hospitals. With today's videoconferencing technologies, many hospitals opted to schedule weekly meetings to discuss difficult or interesting cases with other more specialized hospitals. EMRs allow both the ease of release/communication of data as required for these cases with the retention of unnecessary/private information about the patients.
 
*  Facilitates the communication of patients' data and needs among different hospitals. With today's videoconferencing technologies, many hospitals opted to schedule weekly meetings to discuss difficult or interesting cases with other more specialized hospitals. EMRs allow both the ease of release/communication of data as required for these cases with the retention of unnecessary/private information about the patients.

Revision as of 19:08, 12 September 2011

EMRs have many benefits and return on investments

Benefits

-  Major Healthcare savings - Savings in terms of duplication of services. Records and diagnostics tests can be easily shared among various providers. 
- Reduced Medical errors - There will be reduction in medication error and adverse drug event rate
- Improved care - Better disease prevention and Chronic disease management.

Richard Hillestad, James Bigelow, etal. Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs. Economics Of Health Information Technology Health Affairs, 24, no. 5 (2005): 1103-1117 doi: 10.1377/hlthaff.24.5.1103


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.

--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
- Less errors will reduce the no. of malpractice litigation 
- Reduced reimbursement time & less questionable claims
- Performance would be easier to maintain
- Reduction in hospital lengths-of-stay
- Reduction in nurses' administrative time
- Reduction in drug and radiology usage in the outpatient setting

Return on Investment

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)


Emr systems with business intelligence functionality can measure organizational performance with the IT investment. This capability shows relationship with organizational metrics and the cost savings of the IT investment. --Zoker

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.

Communication

EMR's will enable health care personnel and patients to communicate and exchange data better and in a more accurate and efficient way.

Physician-Physician

  • Access to past records
  • Transitioning care
  • Collaboration in patient care (consultation)

Physician-Patient

  • Best practice guidelines
  • Directed advice
  • Continuity of care
  • Telemedicine

Better data quality and legibility due to:

  • aggregation of data
  • warnings of invalidated data
  • EMR data more legibile than handwritten data

Humpage, Sarah D., "Benefits and Costs of Electronic Medical Records: The Experience of Mexico’s Social Security Institute." Inter-American Development Bank. June 2010. www.iadb.org/document.cfm?id=35219845

Clinical

  • EMRs can help eliminate false negatives by comparing previous and current test results. In a 2003 study, Kleit and Ruiz demonstrated that implementing an EMR reduced the number of false positives mammograms by over 50 percent by making previous mammograms available to clinicians at the time of diagnosis. Previous mammograms did not affect the number of false negatives. Kleit, N. A., Ruiz, J. F. 2003. False Positive Mammograms and Detection Controlled Estimation. Health Services Research, 38(4), 1207-1228.
  • EMR software is packed with many tools to help doctors make better decisions. These tools range from diagnosis to prescribing medications to treatment plan recommendations. Most EMR's have built in PDR-based medication dictionaries providing doctors with Adverse Drug Event (ADE) alerts, generic drug and dosage recommendations.(http://www.emrexperts.com/why-emr.php)
  • In one EMR pilot project to implement EHR in a developing nation (Cameroon), one of the significant benefit was increase in best practices. Boren, Suzanne and Williams, Faustine."The role of the electronic medical record (EMR) in care delivery development in developing countries: a systematic review." Informatics in Primary Care 2008;16:143.

Operational

  • Facilitates the communication of patients' data and needs among different hospitals. With today's videoconferencing technologies, many hospitals opted to schedule weekly meetings to discuss difficult or interesting cases with other more specialized hospitals. EMRs allow both the ease of release/communication of data as required for these cases with the retention of unnecessary/private information about the patients.
  • EMRs allow better integration to other operations such as billing, external departments and patient portals to manage, share, collect and protect the critical medical information. Many EMRs are offered as services hosted over the Internet. This allows clinicians to access them from any location worldwide using cell phone technology or laptops with cellular connectivity. In an implementation like this, patient information can be accessed literally anywhere without having any kind of network connection to the medical facility.
  • EMR systems facilitate the automation of records necessary for audit compliance with federal, state, and accreditation organization regulations. See “EXTRA: Patient Safety in the Physician’s Office: Assessing the Value of Ambulatory CPOE” [[1]]

MikeField 17:54, 23 January 2010 (CST)

  • EHR System provides valuable administrative tools wherein daily reports can be generated. Also, data collected can be sent to a spreadsheet where further analysis, data manipulation, and interpretation can occur. The Financial Impact of an Emergency Department Information System - Michael Hocker, Health Care Technology Volume 2.
  • An 11 study meta-analysis comparing paper vs. electronic demonstrated nurses saved 24 percent of their documenting time when using electronic systems. The studies time savings ranged from 28 to 36 minutes per nurse per eight hour shift. For a 32 bed unit with 1:8 patient to nurse ratio, 36 minutes per shift saves 2 hours 24 minutes. This does not allow for savings by changes in staffing with 1 less nurse. Studies with a more broad perspective suggest savings ranging from 95 to 260 minutes per 12-hour shift for each nurse. This does allow for the possibility of staffing changes, only if nursing operations and cultures can adapt. “Incremental” overtime (OT) costs are incurred when nurses complete documentation at the end of their shifts. Work compiled from 8 hospitals found a range of incremental OT to be from 96 cents to $3.23 per admission (excluding newborns). Nursing leaders estimate potential OT cost reduction of 80 percent, or 77 cents to $2.30 to be expected for a typical 300 bed hospital per non-newborn admissions or a savings of $11,000 to $33,000 per year. A 28 to 38 minute reduction per nurse per shift could reduce or eliminate “incremental” overtime costs. [Thompson MBA, Douglas I, Osheroff MC, Jerry, Classen, MD, David, and Sittig PhD, Dean F. A Review of Methods to Estimate the Benefits of Electronic Medical Records in Hospitals and the Need for a National Benefits Database. Journal of Healthcare Information Management Vol. 21, No.1:67-68]
  • CPOE implementation reduced the mean pharmacy order processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average. Ref: "Effects of computerized prescriber order entry on pharmacy order-processing time" - Jon Wietholter, Susan Sitterson, and Steven Allison
  • Radiological and Laboratory investigations reduced by 18% per week of inpatient hospital stay with implementation of both HER and CPOE. Ref: Zlabek JA, Wickus JW, Mathiason MA. Early cost and safety benefits of an inpatient electronic health record. JAMIA 2011;18:169-172
  • Implementing an EHR can increase reuse of data that is collected at point of care for many groups downstream in the health system. Many times data is recollected and re entered in to various systems which increases time and costs.
  • Having an EHR can facilitate the need for a national person identification number that can be used to identify individuals when seen at various locations. The national person identification number will promote the ability to integrate records from various institutions to give a complete picture of the person by providers.Diabetes information systems: a rapidly emerging support for diabetes surveillance and care. Joshy G, Simmons D.Waikato Clinical School, University of Auckland, Hamilton, New Zealand. joshyg@waikatodhb.govt.nz

  • Pay for performance linked to patient health outcomes are now a real possibility with electronic medical records, which integrate a patient’s medical history, health status and other health indicators in addition to medical visit encounters. Crane, R.M. & Raymond, B. (2003). Fulfilling the Potential of Clinical Information Systems. The Permanente Journal, 7(1), 62-67.
  • Patient portals integrated in electronic medical records, which offer appointment scheduling, retrieval of test results, and other services, make it possible for patients to participate in their health care with their providers. Most savvy healthcare consumers know that they must be active in their own care if they want to obtain the highest quality. Crane, R.M. & Raymond, B. (2003). Fulfilling the Potential of Clinical Information Systems. The Permanente Journal, 7(1), 62-67.
  • EMRs have significant potential to address impending workforce shortage in health care12
  • Greater EMR sophistication may be associated with emergency department (ED) efficiency. Relative to EDs with minimal or no EMR, fully functional EMR was associated with 22.4% lower ED length of stay and 13.1% lower diagnosis/treatment time. However, relationships varied by patient acuity level and diagnostic services provided. (Medical Care and Research Review, 2010 Jun 16; Epub 2010 Jun 16)


  • A 2007 article by Liang, titled ‘The Gap Between Evidence and Practice’, in Health Affairs, discusses the opportunities to improve healthcare by learning from the data available in electronic health record databases in order to bridge the gap between evidence and practice. The paper emphasizes the importance of the use of EHR data for comparative clinical effectiveness research. This potential benefit of EHRs is also addressed by the May 2008 Congressional Budget Office report - ‘Evidence on the Costs and Benefits of Health Information Technology’.
  • Software and hardware vendors are making things easier for doctors with cloud computing and secure web-based computing. These applications let doctors use the same laptops they’ve always used, but it gives them access to large volumes of clinical data, patient history and even 3D avatars that help doctors visualize medical records. The use of EMR as a standard way to exchange healthcare information will lower the costs of healthcare delivery and let physicians get back to the basics — thoughtful, holistic patient care. And it won’t stop there. Doctors will be able to take a proactive role in patient care, anticipating potential problems and dealing with them before they even arise, because they will have visibility into their patients’ complete medical records across the full range of doctors and healthcare providers.[2]
  • Software like Medical Dragon NaturallySpeaking with its ability to produce real-time language as enriched the lives of medical practitioners and their patients. It allows direct data entry by clinicians and staff by voice eliminates the need for transcription. Voice recognition software helps “voice writing” to document a verbatim record of medical examinations and surgeries saving approximately $10,000 per year. Dragon Naturally Speaking costs 80% less than manual medical transcription.[3],[4]
  • EMR allows researchers to efficiently search patient medical information by medical condition, date of treatment, physician name and test category. Researchers can more quickly focus their attention on medical information that supports their research efforts, develop databases to study patient outcomes, and cross-check complex medical information.(http://www.mayoclinic.org/emr/benefits.html)
  • EMR can increase the revenue by giving the ability to offer new services to patients. Many EMR vendors offer features for patients to view their medical information, schedule/cancel appointments and complete forms ahead of time via the organization’s website. This can help attract new business and reduce the load on the staff.(http://www.emrexperts.com/why-emr.php)
  • EMR enables generation of report easily and instantly. Reports can be conveniently generated and programmed to automatic settings. Such reports can be used for assessment of various variables of performance, analysis, compliance and for research studies.
  • Regionally integrated EMRs can help improve the safety of ar-risk patients, or narcotic addicted patients who may visit several emergency departments seeking treatment and medications for their habit. This can save time and cost since these patients may not have health insurance, and time that would have been spent on these patients can be extended to the care of emergency patients.
  • By combining clinical data from EHR with data from other sources such as OTC purchase, school absenteeism rate, it can be used for better monitor of disease outbreaks. Ref: Nir Menachemi, Taleah H Collum. Benefits and drawbacks of electronic health

record systems. Risk Management and Healthcare Policy 2011:4 47–55

EMRs can have a significant effect on patient care when successfully integrated with a fully featured Laboratory Information System (LIS) including:

  • Decrease in patient stays - a delay of a few hours through inefficient ordering processes can increase length-of-stay by up to 24 hours for some tests
  • Results in fewer diagnostic duplications, especially when coupled with a CDSS (which otherwise must be monitored by specially trained nursing or lab personnel
  • Can greatly reduce patient morbidity and mortality (once again especially when coupled with a CDSS) by quick reporting of critical values directly to involved providers.
  • Share integrated information - with better information integration capability, you can facilitate better quality care, contain costs, and better manage risks. MsdC's integrated solutions enable these clinical and business advantages by creating a clinical healthcare system that unites the crucial patient information with the varied departments. This creates a central clinical information repository and resource used throughout your integrated delivery network.[5]
  • Provide rapid access to comprehensive information when needed - fewer misplaced or duplicate charts[6]
  • Adapt to regulatory changes - Meet HIPAA and other legislative and regulatory challenges with organized, complete information. Our clinical information systems allow administrators and management to more easily document and conform to the changes in the regulatory environment. These systems allow auditors and regulators to rapidly assess compliance.[7]
  • Share integrated information - With better information integration capability, you can facilitate better quality care, contain costs, and better manage risks. MsdC's integrated solutions enable these clinical and business advantages by creating a clinical healthcare system that unites the crucial patient information with the varied departments. This creates a central clinical information repository and resource used throughout your integrated delivery network.[8]
  • Compared to paper records, utilizing an Electronic Medical Record (EMR) system is a rapid and efficient method to preserve critical medical information.[9]
  • Better manage risk and lower cost - By consolidating information across your clinical operations, from admission to treatment to labs and beyond, you increase the pace of information flow including service delivery, coding/billing accuracy, and better document patient encounters and work — all while reducing your operating costs. Further, EMR systems provide for more consistent application of medicine protocols. The rapid availability of information 24x7 contributes significantly to better decision making, reduced errors, improved outcomes, and lower malpractice risk.[10]
  • LTAC facility employees who work with EHR systems on a daily basis were positive about their experiences. In particular, operational improvements were achieved through increased access to resident information, cost avoidance, increased documentation accuracy, and implementation of evidence-based practices.

Health_Care_Manage_Rev. 2011 Jul-Sep;36(3):264-74.

  • EHR-based, triggered ADE reporting is efficient and acceptable to clinicians, provides detailed clinical information, and has the potential to greatly increase the number and quality of spontaneous reports submitted to the FDA. Pharmacoepidemiol Drug Saf. 2010 Dec;19(12):1211-5
  • A study performed by Rosen et al. (2011) showed that transitioning a rheumatology practice for children to an EMR resulted in an increase in family satisfaction with an office visit. Kudler, N.R., Pantanowitz, L. (2010). Overview of laboratory data tools available in a single electronic medical record. J Pathol Inform, 3.
  • In 2011, Furukawa concluded that EMRs “may improve provider productivity, especially during visits for a new problem and routine chronic care”. Furukawa, M.F., (2011). Electronic medical records and efficiency and productivity during office visits. Am J Manag Care, 17, 296-303.
  • According to Kudler and Pantanowitz (2010), there are many advantages to having flexible electronic laboratory data in an EMR. For example, laboratory data can be viewed, sorted and pooled to support and determine trend analyses, used for clinical decision making and charting (3). In addition, flexible laboratory data in an EMR has that capacity to help further the development of better clinical decision support tools (Kudler & Pantanowitz, 2010). Rosen, P., Spalding, S.J., Hannon, M.J., Boudreau, R.M., Kwoh, C.K. (2011). Parent satisfaction with the electronic medical record in an academic pediatric rheumatology practice. Journal of Medical Internet Research, 13, 40.
  • Electronic Medical Records (EMR) are beneficial to all parties involved in the managing, receiving and the financial aspect of healthcare which includes the healthcare facility, the patient and the payor of services 1. Reduced offline and in house storage cost of paper based records. Paper records for legal reasons must be kept for several years. When records are not accessed for a certain period of time, they are taken off line and warehoused. Storage of these records is very expensive and time consuming when having to retrieve the document for use. 2. Enhanced Patient care. Patient care improves by having their health information readily available to their clinician for viewing and updating. By having the medical records available to the clinician, the patient can receive timely diagnosis and treatment in addition to reduced healthcare cost from additional test and procedures. 3. Payors such as insurance companies and the government will save from eliminating the cost for additional procedures and possible hospital stay for patients due to lack of correct diagnosis from limited information.

National

  • The American healthcare industry needs a national database of actual EMR implementation results to meet the absence of a low-cost, easy-to-use method for a typical hospital to reasonably estimate the potential benefits of an EMR purchase. This database should include EMR implementation results using 1.common or standardized terms, 2.definitions, and 3.calculation metrics,4.--Kjbracey 14:50, 23 January 2011 (CST) as well as information about the actual EMR implementation environment for truer apples to apples comparison. HIMSS CIS Benefits Taskforce has an initial framework to begin addressing this need. The framework consists of: 1. Hospital Demographic Information 2. Measures to describe the technology infrastructure of the organization 3. Descriptive measures of how the technology is being used by clinicians 4. Benefit categories that are defined 5. System components defined and associated with each benefit 6. Quantitative metrics for each benefit category 7. Entry of above framework data into a web-based data collection tool by hospitals expanding the database and allowing others to find similar hospitals to estimate their own costs [Thompson MBA, Douglas I, Osheroff MC, Jerry, Classen, MD, David, and Sittig PhD, Dean F. A Review of Methods to Estimate the Benefits of Electronic Medical Records in Hospitals and the Need for a National Benefits Database. Journal of Healthcare Information Management Vol. 21, No.1: 66-67]
  • To broadly examine the potential health and financial benefits of health information technology (HIT), this paper compares health care with the use of IT in other industries. It estimates potential savings and costs of widespread adoption of electronic medical record (EMR) systems, models important health and safety benefits, and concludes that effective EMR implementation and networking could eventually save more than $81 billion annually—by improving health care efficiency and safety—and that HIT-enabled prevention and management of chronic disease could eventually double those savings while increasing health and other social benefits(http://content.healthaffairs.org/content/24/5/1103.full)
  • Sound public policy recommendations worthy of serious consideration have been identified by Crane, Raymond [1] to enable widespread clinical IT systems implementation. 1. Leadership in the development of standard clinical vocabulary, standards for exchange of clinical information, and interoperability standards. 2. Barriers to legitimate development and use of clinical information supporting a balance between public privacy right’s and a clinician’s ability, within an uncoordinated delivery system, to manage care and perform research that benefits society. 3. Costs of health information technology (HIT) should be shared among those that benefit. 4. Promotion of and focused study on research and development focused on HIT implementations. The Stimulus Act of 2009 is providing clear movement in this direction[2]. The American Recovery and Reinvestment Act (ARRA), has many implications on health information issues. AHIMA is actively monitoring, participating and developing resources to assist in understanding the key components of this law and the impact on the industry and practice. Information on healthcare reform will be continually evolving. Important HIM issues include: 1. Incentives for adoption of EHRs, 2. Health information exchange (HIE), 3. New privacy regulations for both HIPAA and non-HIPAA entities, and 4. HIM workforce opportunities. [1] Crane MPA, Robert; Raymond MPH, Brian. Fulfilling the Potential of Clinical Information Systems. The Permanente Journal Winter 2003, Vol. 7, No. 1: 66 [2] http://www.ahima.org/arra/
  • With the public and government demand for healthcare reform it is critical that health care technology structure be improved. Implementing EMR will help achieve that success but uptake by the US has been slow with only 7% of the providers using them. Taking the Pulse: Physicians and the Internet(1). (1) New York:Deloitte and Touche 2000. Other industries have improvement in quality, security and productivity using IT infrastructure and it seems this could also translate to the healthcare Industry to slow down the rising healthcare costs while improving quality.(2) A Review of Methods to Estimate the Benefits of Electronic Medical Records in Hospitals and the Need for a National Benefits Database. (2)Thompson, MBA; Osheroff, MD; Classen, MD; Sittig, PhD. Journal of Healthcare Information Management Vol 21.1 pp 63
  • To realize the plan to create a National Health Information Network for providers, hospitals and public health systems an EHR system is needed to facilitate data exchange. The implementation of an EHR system for national use will improve the health of the population which is a goal of the Department of Health and Human Services. An Electronic Health Record - Public Health (EHR-PH) System Prototype for Interoperability in 21st Century Healthcare Systems Anna O. Orlova, PhD,Mark Dunnagan, Terese Finitzo, PhD, Michael Higgins, PhD, Todd Watkins, Allen Tien, MD, MHS, and Steven Beales AMIA Annu Symp Proc. 2005; 2005: 575–579.
  • Regional Health Information Organizations have the potential to revolutionize health care delivery. By connecting disparate providers, payers and other stakeholders, RHIOs are supposed to streamline and accelerate the flow of patient data. Medical records will move seamlessly from doctors’ offices to hospital to outpatient clinic. The ultimate goal is better care for patients, and billions of dollars in savings for the industry as a whole. But RHIOs are still very much in their infancy and are plagued by many unresolved issues, including a clear definition of what they are. [www.hhnmag.com, "A Primer for Building RHIOs", By Dagmara Scalise] [EarnValle9_11_10]
  • HIE and RHIO benefits can be measured along following key axis: 
    •Quality of care improvement by way of greater access to data, newer data sources and technologies
    •Reduction in costs achieved either through efficiency and productivity gains or avoidance of redundant provider services
    •Improved patient experience with the system resulting in higher “customer satisfaction”
    •Compliance with legal, accreditation and standards of care practices
    •Ability to add new revenue stream due to new business opportunity the network creates [11] [EarnValle_9_12_10]
  • One feature of health IT that may qualify as a public good is the wealth of information that can be captured through EHR systems. (As discussed earlier, if researchers

combined data from the EHRs of the population, they might be able to understand the spread and prevention of various diseases and injuries—and eventually develop cures and treatments; assess the effectiveness of various treatments; and more readily detect potential treatment hazards.) [12] [EarnValle_9_12_10]

  • EMRs can support federal and state mandatory reporting requirements. Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly, thus improving disease surveillance and there by promoting early detection of fatal infectious diseases 1, 2.

• Provides complete and accurate access to patient information for providers and demonstrates time saved over paper record. • Expedites results reporting through customizable displays • Supports a common user interfnace for accessing patient information, usually through a workstation. • Supports monitoring and analysis of patient care outcomes

  • On a national and even international level, one benefit of EMR’s is to have potential research information readily available for multiple studies. The result would be not only more data but more immediate data. This allows for more studies to validate or eliminate new approved therapies and medications resulting in improved health care.
  • EMR’s systems that are linked nationally would allow for healthcare workers to identify and treat new outbreaks in infectious/communicable diseases in a specified region. Faster identification of the cause would allow for faster treatment and a decrease in illness and death.
  • Federal government agencies such as the CDC, FDA, VA, HHS will better be able to allocate resources around the country based on data that is collected from an EHR. Such data will allow for improved risk management and planning for disasters such as an epidemic or biological attack.
  • According to Hilstead, et al, massive national adoption of Health IT initiatives may inhibit estimated average savings of "more than $77 billion per year (an average annual savings of S42 billion during the adoption period)". Hillestad et al. Can Electronic Medical Record Systems Transform Health Care? Health Affairs, 24, no. 5 (2005): 107.


EMR Cost Categories

Retrieved from "http://clinfowiki.org/wiki/index.php?title=EMR_Benefits_and_Return_on_Investment_Categories&oldid=11007"