Author Name Jennifer Bresnick | Date June 27, 2014
Use of an advanced EHR system can produce significantly lower per-patient costs in hospitals, says a study published today in the American Journal of Managed Care, with healthcare organizations seeing nearly ten percent in savings from each hospital admission. While EHR adoption and the EHR Incentive Programs have been billed as a way to save billions of dollars for the healthcare system, concrete evidence of a true return on investment has been lacking, leading some providers to question the purpose of the massive and complex implementation process.
The research team from the Medical University of South Carolina used data from the National Inpatient Sample (NIS) and HIMSS to analyze data from more than five million patient cases at 550 hospitals. Advanced EHR users, defined as those with health IT systems that meetmeaningful use criteria, made up 18.9% of the sample. “When controlling for patient and hospital characteristics in the multivariable model, the mean cost per patient admission for hospitals without advanced EHRs was $7938,” the authors write. “The mean cost per patient admission for hospitals with advanced EHRs was $7207,” representing about $730 in savings attributable to EHR use.
“The staging model that was used demonstrates that cost savings may not be realized until multiple features are included and implemented,” the study says. “Since EHR systems are complex and costly to implement, it is often a multistage process to adopt and use EHRs. Thus, hospitals must anticipate that the financial savings may not exist until advanced, ‘meaningful’ use is attained. The majority of hospitals have yet to reach the stage of implementation where cost savings are possible, since they are not using advanced EHRs.”
While the data is encouraging for hospitals still struggling to recoup their investments and return to pre-implementation levels of productivity, the study notes that the same of hospitals is somewhat self-selecting: since the study was conducted in 2009, before meaningful use came into effect, hospitals that had already adopted advanced health IT infrastructures had done so voluntarily. They may have been organizations with visionary plans for organization-wide changes focused on improving care quality and reducing costs through health IT, which would presumably lead to lower over-all costs attributable to more than just the presence of an EHR.
For many hospitals and physician providers, finding the ROI in EHR adoption is still incredibly difficult. Hospitals continue to fall victim to poor implementation practices that leave themdeep in debt or cost top executives their jobs, succumbing to a lack of project management and sufficient staff buy-in to conquer the process. But the benefits of health IT adoption may eventually outweigh the difficulties, predict EHR advocates.
“We are only three years into the process of making digital information widely available in health care,” notes former National Coordinator Dr. David Blumenthal. “And health care is an extraordinarily complex, knowledge-intensive industry. When you change the way information is used and collected in medicine, you change everything about the way work is done. It is an enormously disruptive process within the health-care system. It takes time to accommodate.”
