A team of researchers from across the industry have developed a framework for assessing the return on investment of health information systems.
The Institute of Medicine has published the framework as a discussion paper, available here. Although it may seem obvious that both the demands for higher reliability and higher-value health care require robust electronic health records, information exchange and deep analytic capabilities, it remains difficult to measure the return on investment in information systems, the authors note. The lack of a standard model for ascribing the costs of implementing or the benefits of using EHRs and related technology makes comparisons across different institutional experiences, different implementation approaches, and different technologies difficult. Moreover, the absence of a format for a standard business case for information investment may add to the hesitation for investment in information systems and thwart progress in creating the reliable digital foundation needed for a continuously learning health system.
If the industry is to have rational discussions about the value and comparative effectiveness of EHR integration, general standards are needed, the authors contend. A standardized but flexible framework for calculating ROI from information systems can support investment decisions such as timing and product selection. Consequently, the authors have built and are proposing a standard model of evaluation. They identified potential expenses, benefits and revenue impacts, as well as methods for financial prioritization and measurement.
The discussion paper includes multiple tables, such as stakeholders affected by EHR investments and why they are affected. These include the provider institution, patients, patients employer, patients family, purchaser, physician/care providers, society, post-acute care providers, pharmaceutical manufacturers, supply manufacturers, support staff, policy makers and researchers.
Another table lists 28 types of expenses, a description of each, the stage during which they are incurred, and the category (hardware, software, consulting, training, etc.). There also is a similar table of 32 benefits that shows how they align with meaningful use goals, and a table of 14 potential revenue impacts.
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