Sample Questions & Answers

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 forall 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.

  1. I am in a four-person practice. What will the cost of an electronic medical record (EMR) implementation be for me?
  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?
  3. I want to implement computerized physician order entry (CPOE) in my hospital. What is the cost? What are the caveats?
  4. 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?
  5. 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 1. I am in a four-person practice. What will the cost of an electronic medical record (EMR) implementation be for me?
Using the criteria of electronic health record and cost effectiveness and cost benefit we get the following:

NOTE: Below is an example screenshot of the search criteria you can use. Perform a search on the database.

screenshot of the search criteria for Question 1

The first article provides the following summary data for a small (three-physician) practice:

Improved productivity Workload Illustrated benefits of AEHR
Elimination of chart pulls 120 chart pull/day, each taking 5 minutes (1,000 hours of work annually) 1000 hr/yr * $17/hr = $17,000/yr
Reduction/elimination of transcription costs 12000 visits/yr * 40 lines of transcription * $0.11/line $52,800 yearly savings minus increased provider time for documentation = $42,680/yr net savings
Automatic documentation of diagnostic codes 12000 visits/yr * 2 codes/visit *15% manually researched * 5 minutes/code = 300 hours coding time CPR can virtually eliminate the cost of coding time, resulting in a saving of $5100/yr

This can be used to make a case to management for implementation of an EHR. The second article (although in Sweden) also provides perspective on EHR implementation in the outpatient setting but breaks down the cost by category:

Category Description Monetary value (in SEK, 1995 dollars)
Direct costs Training 54,000
Hardware and software (NPV) 1,471,700
Project manager system supplier 6,700
Maintenance 109,700
Total direct costs 1,642,100
Unexpected costs Self-training during working hours 109,100
Loss of normal activities in leisure hours 69,100
Increase in administrative work load 192,000
Extra service 3,300
Summarizing medical records 77,400
Total unexpected costs 450,900

The sixth article provides summary data for a small independent family physician clinic: