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Yael Harris, PhD, MHS Senior Policy Analyst

Measuring Return on Investment: Comparing Apples to Oranges (or at least Macintosh to Granny Smith). Yael Harris, PhD, MHS Senior Policy Analyst Office of the National Coordinator for Health Information Technology. A Quick Review of the Literature.

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Yael Harris, PhD, MHS Senior Policy Analyst

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  1. Measuring Return on Investment:Comparing Apples to Oranges(or at least Macintosh to Granny Smith) Yael Harris, PhD, MHS Senior Policy Analyst Office of the National Coordinator for Health Information Technology

  2. A Quick Review of the Literature • $339,662 total annual savings in practice of 28 MDs using EHRs- Grieger, Cohen, Krusch, 2007 • Estimated net benefit of using EMR over 5 year period: $86,400 per physician- Wang, Middleton, Prosser, et. al., 2003 • Nationwide savings of $21.3 billion within 5 years of 90% adoption- Hillestad, Bigelow, Bower et. al. 2005 • Use of EMRs can result in poorer quality (and possibly higher overall costs as a result)- Linder et. al. 2007

  3. What are we measuring? • Electronic Administrative Record? • Computerized Physician Order Entering? • E-labs? • Medication Management? • Clinical Decision Support?

  4. A Plea for a Standardized Definition • ONC funded study by George Washington /Harvard • What constitutes an Electronic Health Record (EHR) • How to measure adoption

  5. Results • 4 Functionalities • Electronic notes • Electronic ordering of lab tests • Electronic receipt of lab results • Electronic ordering of medications

  6. So, What is Current Adoption Rate? • 9.2% for physician offices • Rate much lower for small and solo practices • Rate lower in rural areas • Highest rates in New England

  7. Ongoing Measurement • 2007 Comprehensive survey of adoption • Identify types of practices that have adopted • Identify practices planning to adopt • Identify barriers • Identify cost tradeoffs • 2008 & going forward- National Ambulatory Medical Care Survey (NAMC)

  8. So, is there a return on investment? • Technology type • “Adoption” of EHR • Practice size • Time since implementation • Start up costs

  9. Questions? Yael Harris 202-205-3628 Yael.harris@hhs.gov

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