The value of healthcare IT - Special Advertising Section - determining the value of potential investments in healthcare information technology

Healthcare Financial Management, Jan, 2003

Bates reported that the average cost of an ADE to Brigham and Women's was $2,595. "For our institution, the costs of developing and implementing physician computer order entry have been estimated to be $1.9 million, with maintenance costs of $500,000 per year. The net savings have been estimated to be between $5 to $10 million per year," writes Bates. (30) Much of this savings has been achieved through cost-efficient drug selection and the use of laboratory and clinical pathways. (31) "The system enhances quality of care by averting potentially dangerous situations. Cost savings are a by-product," comment Stephanie Reel and colleagues. (32)

LDS Hospital

Another cost-effective method of reducing the frequency of adverse drug events is the use of a computerized decision support system (CDSS). A CDSS is defined as "software that integrates information on the characteristics of individual patients with a computerized knowledge base for the purpose of generating patient-specific assessments or recommendations designed to aid clinicians and/or patients in making clinical decisions." (33)

Through use of a CDSS developed by Intermountain Health Care, clinicians at LDS Hospital, a 500-bed teaching facility in Salt Lake City, significantly reduced ADEs related to antibiotics. (34) Using data in the patient record, the CDSS evaluated the need for antibiotics and other anti-infective agents, provided drug recommendations, and calculated the appropriate dose and dosing interval based on measures of the patient's renal and hepatic function. (35) Use of the system resulted in a 75% decline in ADEs due to incorrect drug selection and incorrect dosages, among other factors. Reduction in ADEs meant lower lengths of stay and reduced costs.

Who's Doing What, Where, and How

Two contemporary examples can help leaders get a feel for the IT ROI analyses being performed currently by healthcare organizations.

Maimonides Medical Center

Winner of the prestigious 2002 Nicholas E. Davies Recognition Award from HIMSS, Maimonides Medical Center successfully implemented a computer-based patient record (CPR) with knowledge-based decision support. Called the Maimonides Access Clinical System (MACS), it incorporates four distinct electronic medical record systems--an inpatient CPR, ambulatory care CPR, perinatal CPR, and emergency department CPR--from different vendors. MACS successfully transformed the organization from one whose information environment remained in the dark ages to one of an elite group of information-driven healthcare organizations that serve as a model for other hospitals nationwide.

Located in densely populated Brooklyn, New York, Maimonides Medical Center is a 705-bed hospital that provides care for more than 37,000 inpatients, 77,000 emergency department patients, and 253,000 outpatients each year. It has a staff of 4,600 and approximately 1,200 employed or affiliated physicians.

The organization's mission in the mid 1990s was to develop a leading edge CPR system to improve the quality and effectiveness of patient care by providing real time access to comprehensive clinical information wherever and whenever needed. The leadership team established the following strategic objectives for the CPR system: