Mannle TE, Gaylin DS, White LE; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1997; 14: 9-10.
The Lewin Group, Fairfax, VA 22031, USA.
RESEARCH OBJECTIVE: To develop a model for Veterans Health Administration (VHA) that identifies, measures, and monetizes the clinical benefits of implementing an integrated hospital information system (HIS). STUDY DESIGN: We conducted site visits to pilot implementation sites and developed a framework for calculating the benefits in clinical processes obtained through implementing an HIS with computerized patient records, integrated imaging capabilities, and clinical decision support tools. Clinician interviews and literature searches identified three imaging capabilities, and clinical decision support tools. Clinician interviews and literature searches identified three broad areas of realizable benefits: 1) benefits from reduced order transaction time: 2) benefits from improved information integration and retrieval; and 3) benefits from improved clinical decision-making. These benefits were quantifiable, respectively, as clinical (e.g., physicians, nurses, clerks) time saved during order transactions, physician time saved from immediate access to patient information, and decreased incidence of adverse drug events and their associated costs. Initial and follow-up site visits to each pilot implementation site provided data on baseline and post-HIS implementation clinical processes. To value benefits in each area, we developed a detailed spreadsheet model incorporating the site visit data and institutional-specific data on patient volume, clinician salary, charges per services, and level of utilization. PRINICPAL FINDINGS: In aggregate, the four Veterans Health Administration pilot hospitals could expect to realize over $22.6 million in clinical benefits. Of this total, benefit area 1 contributed $15.8 million, benefit area 2 contributed $5.7 million, and benefit area 3 contributed $1.2 million. Of the $22.6 million, benefits for inpatient services accounted for $9.4 million, and benefits for outpatient services accounted for $13.2 million. We also estimated that during the first year of implementation, factors of incomplete clinical workstation saturation, incomplete clinical workstation adoption, and incomplete user proficiency produce underutilization of the HIS, resulting in 25 percent lower clinical benefits than could be expected under optimal utlization. Despite this loss of potential benefits, in the first year of implementation, projected savings exceeded projected costs (for system development, hardware, software, installation, maintenance, and training) by $5.8 million. These results are conservative--sensitivity analyses suggest that the total projected benefits could be overestimated by 6 percent and underestimated by 47 percent. CONCLUSIONS: Net benefits of implementing the system are positive and substantial. Thus, for the Veterans Health Adnimistration, HIS implementation is an investment worth pursuing at other VHA hospitals. Further, because environmental factors can reduce the potential benefits, saturation and training become important vehicles for ensuring the largest possible benefits. This model offers a broadly applicable tool for quantifying clinical benefits produced by HIS implementation in both VHA and non-VHA settings. RELEVANCE TO CLINICAL PRACTICE, MANAGEMENT AND POLICY: With increasing pressure to cut costs and improve services, hospitals are contemplating large investments in information technology enhancements. This model offers hospital decision-makers a method for assessing the returns on these investments.
Publication Types:
Keywords:
- Computer Systems
- Cost-Benefit Analysis
- Costs and Cost Analysis
- Health Personnel
- Hospital Information Systems
- Humans
- Investments
- Medical Records Systems, Computerized
- Models, Biological
- Software
- economics
- hsrmtgs
Other ID:
UI: 102233424
From Meeting Abstracts