Health IT Survey Compendium
The Health IT Survey Compendium provides a centralized resource of publically available health IT surveys, many of which were developed by AHRQ-funded projects. Surveys may be used as is, serve as templates to create new surveys, or questions pulled out and used on their own.
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Description: [[{"type":"media","view_mode":"media_large","fid":"569","attributes":{"alt":"Consumer Health Information Technology in the Home: A Guide for Human Factors Design Considerations","class":"media-image hit-style-float-left","height":"91","width":"100"}}]]Every day, in households across the country, people engage in behavior to improve their current health states, recover from disease and injury, or cope with chronic, debilitating conditions. Innovative computer and information systems may help these people manage health concerns, monitor important indicators of their health, and communicate with their formal and informal caregivers. Designers and developers can help change the face of health care at home by creating appropriate consumer health information technology (IT) applications. This guide introduces designers and developers to the practical realities and complexities of managing health at home. It provides guidance and human factors design considerations that will help designers and developers create consumer health IT applications that are useful resources to achieve better health. To download the guide go to: http://www.nap.edu/catalog.php?record_id=13205
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Description: [[{"type":"media","view_mode":"media_large","fid":"570","attributes":{"class":"media-image hit-style-float-left","height":"67","width":"100"}}]]This guide describes what is needed to evaluate a health information exchange (HIE) project and develop a realistic evaluation plan. It consists of six sections to assist users in all steps of the HIE project evaluation planning process. It also includes six appendixes that provide additional resources to help capture needed information to include in the plan., Download Full Guide and Appendixes, ( HIE Evaluation Toolkit PDF , 2.27 MB), Individual Sections and Appendixes, Six sections and several appendixes, which also can be downloaded individually, are included:, Selecting Your Evaluation Team., ( Selecting Your Evaluation Team PDF PDF , 132 KB) Provides guidance regarding the roles and expertise of an ideal HIE project evaluation team as well as information to help you plan for the skills and expertise needed to successfully conduct your evaluation. , Characterizing Your HIE Project., ( Characterizing your HIE project PDF PDF , 124 KB) Prepares your team to create the evaluation plan by describing the overall HIE project, identifying stakeholders, and articulating the project’s goals and objectives. , Assessing the Value of HIE., ( Assessing the value of HIE PDF PDF , 224 KB) Discusses the rationale and requirements for assessing the value of HIE and provides an overview of relevant issues. , Developing Your Evaluation Plan., ( Developing your evaluation plan PDF PDF , 404 KB) Provides an overview of how to use a step-by-step process to develop an evaluation plan that meets stakeholder needs. , Creating Your Dissemination Plan., ( Creating your dissemination plan PDF PDF , 161 KB) Offers guidance on how to create a plan to disseminate the results of the evaluation to your stakeholders and highlights key requirements for effective dissemination. , Examples of Evaluation Measures., ( Examples of evaluation measures PDF PDF , 868 KB) Provides examples of measures that you might use in an evaluation, based on those reported in the literature and other HIE project evaluations. , Appendixes., The appendixes provide additional resources to help you capture the information required for the development of your HIE project evaluation plan. , Appendix A: Workbook, ( Appendix A PDF PDF , 245 KB) is a step-by-step workbook that guides you through the key evaluation planning steps and helps to document evaluation priorities, decisions, and candidate measures. , Appendix B: Sample Literature Search Strategy, ( Appendix B PDF PDF , 130 KB) is a sample literature search strategy that you could use to identify potential measures. , Appendix C: Tips for Facilitating Brainstorming, ( Appendix C PDF PDF , 114 KB) provides helpful suggestions on brainstorming as a way to generate potential measures. , Appendix D: The Importance of Sample Size, ( Appendix D PDF PDF , 119 KB) includes a sample calculation and discussion of the importance of sample size. , Appendix E: Glossary, ( Appendix E PDF PDF , 70 KB) offers a glossary of key terms used in the Guide. , Appendix F: Resources, ( Appendix F PDF PDF , 245 KB) provides an annotated list of resources for sections of the Guide.
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Description: [[{"type":"media","view_mode":"media_large","fid":"574","attributes":{"alt":"Health IT Evaluation Toolkit","class":"media-image hit-style-float-left","height":"80","width":"100"}}]], Health IT Evaluation Toolkit, This toolkit, which was designed to help project teams develop an evaluation plan of their health IT project, consists of three sections: Section I outlines a step-by-step process for a team to determine what the goals of a given project are, what is important to their stakeholders, what needs to be measured to satisfy those stakeholders, what is truly feasible to measure, and how to measure those items. Section II includes a list of measures that are often employed in health IT projects. Each of the provided tables includes a list of possible measures, suggestions on data sources that can be leveraged for each measure, cost considerations, potential pitfalls, and general notes. Section III contains some examples of a variety of implementation projects., Download Health IT Evaluation Toolkit, ( HIT Evaluation Toolkit PDF , 384 KB) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Email Corey Mackison Corey Mackison ), Health IT Evaluation Measures - Quick Reference Guides, The guides expand individually on some of the measures included in the Health IT Evaluation Toolkit and provide details about individual measures that can be incorporated into a health IT evaluation plan. Each guide includes a brief description of the measure, summary of current literature on the measure, measurement methodology, and study design and analysis considerations. The guides provide a starting point for evaluators in the development of an evaluation plan for a given measure., Impact of Health IT on Nurses' Time Spent on Direct Patient Care, ( Impact of Health IT Nurses' Time Spent on Direct Patient Care PDF , 112 KB): Monitoring nurses' time spent on activities related to patient care allows organizations to measure whether the introduction of health information technology (IT) decreases administrative tasks, thereby potentially impacting nurse time spent on direct patient care., Improved Accuracy of Coding, ( Improved Accuracy of Coding PDF , 100 KB): Monitoring the use of current procedural terminology (CPT) codes can help organizations determine whether health information technology (health IT) improves coding accuracy and completeness by providing decision support for documentation activities., Length of Stay, ( Length of Stay PDF , 104 KB): This measure allows organizations to systematically assess the impact of implementing health IT with the intent to decrease inpatient length of stay (LOS)., Medication Turnaround Time in the Inpatient Setting, ( Medical Turnaround Time in the Inpatient Setting PDF , 111 KB): Medication turnaround time is defined as the interval from the time a medication order is written (manually or electronically) to the time the medication was administered. Monitoring medication turnaround time in inpatient settings allows organizations to measure the impact of their health IT application on the increased efficiency of patient care., Patient Use of Secure Messaging, ( Patient Use of Secure Messaging PDF , 122 KB): Monitoring the use of secure messaging by patients over time is one way to measure the success of the implementation of secure messaging functionality, which may be made available through a patient portal or a personal health record (PHR)., Percentage of Alerts or Reminders That Resulted in Desired Action, ( Percentage of Alerts or Reminders that Resulted in Desired Action PDF , 115 KB): Determining the frequency in which a given alert or reminder is executed may help assess its effectiveness., Prescribing Patterns of Preferred or Formulary Medications, ( Prescribing Patters of Preferred or Formulary Medications PDF , 102 KB): Evaluating the prescribing patterns of preferred or formulary medications can help organizations determine whether health IT, in particular, electronic prescribing (e-prescribing) and computerized provider order entry (CPOE) systems with included formularies, impact the use of preferred or formulary medications., Percentage of Orders Entered by Authorized Providers Using CPOE, ( Percentage of Orders Entered by Authorized Providers using CPOE PDF , 107 KB): Monitoring who uses computerized provider order entry (CPOE) allows organizations to measure CPOE use by providers versus their proxies over time and is one way to evaluate the success of their implementation., Prescribing Patterns of Cost-Effective Drugs, ( Prescribing Patterns of Cost-Effective Drugs PDF , 94 KB): Evaluating the costs of prescription drug expenditures can help organizations determine whether health IT, in particular, electronic prescribing and computerized provider order entry (CPOE) with clinical decision support, impact the use of cost-effective medications., Percentage of Verbal Orders, ( Percentage of Verbal Orders PDF , 94 KB): Monitoring the percentage of verbal orders allows organizations to measure the use of verbal ordering over time and whether that use is trending downward with the implementation of health IT, most commonly, computerized provider order entry (CPOE)., Reduction in Hospital-Acquired Complications and Infections, ( Reduction in Hospital-Acquired Complications and Infections PDF , 135 KB): Monitoring the number of hospital acquired complications and infections can help organizations determine whether health IT has impacted patient safety in hospital settings.
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Description: [[{"type":"media","view_mode":"media_large","fid":"485","attributes":{"alt":"Accessible Health Information Technology (IT) for Populations with Limited Literacy: A Guide for Developers and Purchasers of Health IT (Report Cover)","class":"media-image hit-style-float-left","height":"256","width":"199"}}]]As most health information technology (IT) developers have little knowledge of populations with limited literacy and of the technical standards and aspects of accessible health IT design, this guide and checklist provide a structure, strategies, and other resources for the development of these technologies. Similarly, purchasers of health IT (e.g., heath plans, pharmaceutical companies, foundations, and other non-profit organizations) that desire to make technologies available to limited-literacy adults, can use this guide and checklist to evaluate a health IT product. For those purchasers who contract out the development of their product, this guide can be used to direct and validate the developer's work., Download the Report, Download the guide ( Health IT Literacy Guide PDF , 268 KB, Health IT Literacy Guide Text *) *This version of the report is formatted for compliance with Section 508 of the Rehabilitation Act.
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Description: Contact Information, For technical assistance concerns, please contact your Program Official.
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Description: [[{"type":"media","view_mode":"media_large","fid":"16821","attributes":{"alt":"Picture of a Safe Lock","class":"media-image hit-style-float-left","height":"86","width":"100"}}]]What is the Health Information Security and Privacy Collaboration Toolkit?, This toolkit provides guidance for conducting organization-level assessments of business practices, policies, and State laws that govern the privacy and security of health information exchange (HIE) . The toolkit was developed as part of the Agency for Healthcare Research and Quality (AHRQ) and Office of the National Coordinator for Health Information Technology (ONC) joint-funded Health Information Security and Privacy Collaboration (HISPC) project. For more information on the HISPC project, HISPC click here ., How Can a State or Region Use the Toolkit?, Assessing the variation in organization-level business practices enables regions, States, and territories to identify the variation in practices, policies, and laws that may present barriers to interoperable health information exchange. The assessment will help to identify specific practices that may pose challenges (e.g., the requirement for a wet signature), as well as practices that facilitate interoperable exchange (e.g., acceptance of digital signatures). This, in turn, will allow investigators to identify and propose practical solutions to barriers while preserving privacy and security requirements as defined by the local community and in applicable federal and State laws and will enable them to develop detailed plans for implementing solutions., Download the Toolkit, Overview explaining each component of the toolkit, click here ( Toolkit Component Overview PDF , 127 KB) Complete toolkit ( All Toolkit Components ZIP , 155 KB). To access individual components and their descriptions, scroll down the page or click on the links below., Section 1: Tools, Scenarios Scenarios Guide Dimensions of Business Practices Dimensions of Business Practices Data Collection Templates Guidelines for Describing Business Practices Example Business Practices Stakeholder Meeting Discussion Guide Stakeholder Meeting Checklist Stakeholder Meeting Debriefing Guide, Section 2: Reference Materials, Reference Library Existing Guidance to Support HIE Implementation Opportunities Relevant Legal Requirements for Health Data Exchange for Health Care Organizations IT Privacy and Security Primer Glossary, Toolkit Components, Section 1: Tools, Section 1 presents the basic tools for assessing variation in business practices, as well as materials that facilitate productive meetings with stakeholders. Scenarios Guide ( Scenarios Guide PDF , 188 KB) This document includes the text of the 18 health information exchange scenarios, along with suggested areas for discussion associated with each scenario. The scenarios were developed by the American Health Information Management Association (AHIMA). Scenarios describe different purposes for health information exchange, including treatment, education, research, marketing, public health, and biosurveillance, to ensure a thorough review of relevant business practices. Use the scenarios guide to stimulate discussions with relevant stakeholders about business practices associated with privacy and security issues encountered in an array of health information exchanges. Dimensions of Business Practices ( Dimensions of Business Practices PDF , 129 KB) This document defines the 9 domains of privacy and security used by the state teams, describes the dimensions of business practices associated with each domain, and provides examples of business practices. Use this tool to develop a thorough understanding of the scope of the project before holding meetings to collect business practice information. Understanding the dimensions of business practices that are relevant to the defined domains of privacy and security as explained here will help focus discussion on privacy and security issues. Although they are important, issues such as the adoption of health information technology and technology standards are not strictly within the scope of this effort. Data Collection Templates ( Data Collection Template XLS , 88 KB) This Excel file reproduces the data fields completed by the state teams. These data fields allow investigators to link business practices to scenarios, domains, and affected stakeholders and to capture descriptions of key business practice drivers, such as business policies and relevant laws. Entering data into the spreadsheet ensures that all items have been captured for each business practice and allows investigators to sort information for analysis. Guidelines for Describing Business Practices ( Guidelines for Describing Business Practices PDF , 126 KB) This document provides detailed instructions for collecting complete and useful data in each of the fields in the data collection template. By following these guidelines, investigators can ensure that business practices are thoroughly discussed and described and that results comparable with those achieved by the state teams are obtained. Understanding these guidelines prior to collecting data will help ensure the efficiency of the data collection process, limiting the need to retrieve missing data. Example Business Practices ( Example Business Practices XLS , 25 KB) The examples provided here demonstrate the principles described in Tool 4, Guidelines for Describing Business Practices. The top two rows in the example spreadsheet, "Description of Data Item" and "Specific Notes and Comments," provide additional explanations of each data item and the processes by which they may be collected. By comparing collected data with these examples of complete and useful data early in the assessment process, investigators can ensure the utility of the information they collect. Stakeholder Meeting Discussion Guide ( Stakeholder Meeting Discussion Guide PDF , 214 KB) This guide was developed by RTI expressly for this toolkit to enable users to reproduce the process used by the state teams. It is designed to help meeting facilitators elicit business practices and link them to drivers (policies and laws), domains, and affected stakeholders. Use the discussion guide during meetings with stakeholders to ensure active and effective participation of all attendees. Stakeholder Meeting Checklist ( Stakeholder Meeting Checklist PDF , 82 KB) This document describes procedures that will help meeting facilitators prepare for effective stakeholder meeting discussions. Use the checklist to ensure that all materials needed for an effective meeting are on hand. Stakeholder Meeting Debriefing Guide ( Stakeholder Meeting Debriefing Guide PDF , 106 KB) This document is designed to help meeting facilitators evaluate the effectiveness of stakeholder meetings. The core group of investigators should use this debriefing guide after stakeholder meetings to evaluate the effectiveness of meetings and make any necessary adjustments to improve the effectiveness of future meetings., Section 2: Reference Materials, Reference Library ( Reference Library PDF , 116 KB) This document was created by the Privacy and Security Project's Technical Advisory Panel as background material for participants on the state teams. It provides references and links to relevant publications. Existing Guidance to Support HIE Implementation Opportunities ( Existing Guidance to Support HIE Implementation Opportunities PDF , 119 KB) This document provides guidance regarding the implementation of solutions. While investigators should implement solutions that address circumstances in their own state or territory, inconsistent solutions in key areas may raise new barriers to interstate activities and transactions. Reference to and use of nationally recognized guidance to support implementation helps minimize the risk of this kind of inconsistent development. Relevant Legal Requirements for Health Data Exchange for Health Care Organizations ( Relevant Legal Requirements for Health Data Exchange for Health Care Organizations PDF , 246 KB) Created by the Privacy and Security Project's Technical Advisory Panel as background material and provided to state teams at the outset of the project, this document provides basic information about key legal issues affecting health information sharing. IT Privacy and Security Primer ( IT Privacy and Security Primer PDF , 301 KB) Created by the Privacy and Security Project's Technical Advisory Panel as background material and provided to state teams at the outset of the project, this document provides helpful discussions of many dimensions of the HIPAA Privacy and Security Rules. Glossary ( Glossary PDF , 92 KB) Created by the Privacy and Security Project's Technical Advisory Panel as background material and provided to state teams at the outset of the project, this document was compiled as a companion to reference materials C and D, to ensure consistent understanding of the terms used in those documents. It also serves as a useful guide to key concepts in the area of electronic health information exchange.
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Description: [[{"type":"media","view_mode":"media_large","fid":"580","attributes":{"alt":"Time and Motion Studies Database ","class":"media-image hit-style-float-left","height":"66","width":"100"}}]]The application of computing to health care changes how, when, and where clinicians collect and retrieve patient information. Measuring the impacts of technology on clinical tasks often involves performing a time and motion study. In a time and motion study, observers follow clinicians and record how long specific tasks, such as signing a medication prescription or listening to a patient describe her symptoms, take to complete. Researchers and practice managers use time and motion study data to evaluate whether and to what extent health information technology applications, including computerized provider order entry, electronic prescribing, and electronic health records, increase efficiency - for example, by helping clinicians perform routine tasks faster., Resources for Time and Motion Studies, Researchers at Partners Healthcare have created a tool to help others accurately capture time and motion study data. The tool - a Microsoft Access database - allows observers to record time and motion data and store them for analysis. In addition, Partners has created a user's guide for this new tool and published a journal article that provides a case example of how the tool can be used to evaluate the effectiveness of a health information technology. Together, the tool, the user's guide, and the journal article can help you measure the impact of technology on clinical workflow. Time and Motion Database ( MDB , 464 KB) Time and Motion Database User's Guide ( User's Guide PDF , 456 KB) Time and Motion Journal Article ( Time and Motion Journal Article PDF , 0.93 MB, Abstract on PubMed PubMed Abstract ) , How AHRQ Grantees Are Using Time and Motion Studies to Measure Health IT Impacts, Grant: R01 HS015430 Project Title: Health Information Technology in the Nursing Home Principal Investigator: Jerry Gurwitz, MD This grant is examining the extent to which adding clinical decision support (CDS) to a computerized provider order entry (CPOE) system will improve quality and reduce costs associated with medication ordering and administration for residents in long-term care facilities. A major component of the grant involves analyzing the CDS' impact on staff time, including the time of physicians entering medication orders, the time of pharmacists and pharmacy technicians filling medication orders, and the time of nurses administering medications to residents. Overall, the grant will explore whether improved prescribing practices reduce costs associated with filling and administering medications. In addition to the time-motion data, the project investigators will track medication prescribing and administration to estimate the cost of care delivery to residents. In this project, observers are using personal digital assistants (PDAs) running PocketTimer from Stevens Creek Software, Inc. to track times manually. To capture data related to the steps in the medication handling activities performed by nurses, pharmacists, and physicians, the project investigators developed categories of tasks for each profession, using an approach similar to that used in a previous time-motion study ( Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices. Overhage, et al ). Final results and outcomes are expected in late 2007, and the project researchers plan to publish their findings in academic journals, as well as on the AHRQ Web site. Grant: UC1 HS015319 Project Title: Evaluating the Impact of an ACPOE/CDS System on Outcomes Principal Investigator: Sean D. Sullivan, PhD, RPh This grant is examining the impact of electronic prescribing (e-prescribing) on medication errors at The Everett Clinic, an integrated ambulatory health system. Many experts believe that e-prescribing, a function of an ambulatory computerized provider order entry (ACPOE) system, reduces the incidence of medication errors by ensuring legibility and completeness of the prescription, and by alerting physicians to potential drug interactions and patient allergies. Some physicians, clinic administrators, and researchers are concerned that ACPOE systems may negatively affect clinical workflow -- the tasks and processes performed by nurses and physicians -- by increasing the time it takes nurses and physicians to do their job. Researchers at the University of Washington and The Everett Clinic designed a time-motion study to evaluate the impact of e-prescribing on physician and staff time spent on prescribing-related activities. Hopefully, the time-motion study will reveal that e-prescribing has only a small impact on physician and staff time, and that the safety benefits of e-prescribing will outweigh this potentially minor impact on clinical workflow. The time-motion component of the grant involves observing physicians and clinic staff to capture all their activities, including those that are prescribing-related. Observers use personal digital assistants (PDAs) running TimerPro software by Applied Computer Services, Inc., to record clinic activities. The software running on the PDAs was customized to reflect the categories and tasks of interest to the investigators and the clinic staff, and was based in part on a previous study ( Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices. Overhage, et al ). As of September 2006, the investigators had completed a preliminary manuscript for submission to an academic journal. Final results and outcomes are expected in 2007, and the researchers intend to publish them in an academic journal, as well as on the AHRQ Web site.
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Description: NSF, in collaboration with the Health Information Technology (IT) Portfolio at the Agency for Healthcare Research and Quality (AHRQ), will accept and review investigator-initiated proposals that address systems modeling in health services research. The Service Enterprise Systems program in the Civil, Mechanical, and Manufacturing Innovation (CMMI) division of the Engineering Directorate will be the lead program on this interdisciplinary topic. Through this partnership, NSF and AHRQ look to foster new collaborations among health services researchers and industrial and systems engineers with a specific emphasis on the supportive role of health IT. For more information go to: http://go.usa.gov/Iof.
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Description: DISCLAIMER, The studies referenced here were reported in peer-reviewed publications as systematic reviews, hypothesis tests, or predictive analyses. Although the results are valid for the institutions they represent, they may not be valid for other organizations with different technical capacities, project management expertise, organizational culture, or human and economic resources - all of which may affect cost. In addition, these studies may not contain the full technical details of how health information technology was implemented or how it operates. Thus, these results are best used as general guidelines for determining costs and benefits rather than as absolutes, because they may not hold true for all organizations. Please refer to Chapter 4 of "Costs and Benefits of Health Information Technology," AHRQ Publication No. 06-E006, for additional information on the limitations and conclusions of the studies included in the evidence report. I am in a four-person practice. What will the cost of an electronic medical record (EMR) implementation be for me? We are a small practice being asked to participate in a regional health information exchange. What are the pros and cons of doing this? What workflow and productivity changes can we expect? I want to implement computerized physician order entry (CPOE) in my hospital. What is the cost? What are the caveats? We are a small practice interested in improving care effectiveness by implementing an electronic health record (EHR) system. What does the research tell us on whether and how we can succeed? We've been asked to implement a computerized physician order entry (CPOE) CPOE system as part of a patient safety initiative. What can we really expect in terms of health benefits from CPOE? Question 2. We are a small practice being asked to participate in a regional health information exchange. What are the pros and cons of doing this? What workflow and productivity changes can we expect? Checking Data Exchange and all the boxes under cost/benefits outcomes we get the following: NOTE: Below is an example screenshot of the search criteria you can use. Perform a search on the database . screenshot of the search criteria for Question 2 The second article describes the cost of implementing a health information exchange. The summary is presented below. Estimated cost is $20,000 for software and $15,000 for interfaces per facility., Settings, : N/A, Evaluation Method, : Mixed methods were used to define the models and estimate costs. An expert panel defined a functional model for a national health information network. The panel achieved consensus through a modified Delphi method. Estimates for costs were based on data taken from the Santa Barbara County Data Exchange, a regional network designed to exchange health data within Santa Barbara County, CA. Secondary data were taken from the 2000 U.S. Census Bureau and the National Center Health Statistics., Description, : The model delineates a national health information network that is "achievable and desirable" in five years rather than an "ideal infrastructure." The projects expert panel selected the following functional domains to be critical to a national health information network: inpatient/ outpatient results viewing, Electronic Health Records, computerized provider order entry, electronic claims submission, electronic eligibility verification, secure electronic patient communication, and electronic prescriptions., Interoperability, : The model assumes a brokered peer-to-peer architecture in which data were exchanged over the internet. Interoperability in the model is supported through software interfaces being implemented to allow different Health IT systems to exchange data., Barriers, : Costs, complexity of integration of information through software interfaces. Costs: Total costs to achieve a national health information network in five years were estimated to be $156 billion dollars in capital costs and $48 billion per year in operating costs., Cost of Health IT systems, : The total cost to achieve functionality of a model network in five years was estimated to be $103 billion in capital costs. The total costs to construct a brokered peer-to-peer communication network was estimated to be $53 billion in capital costs., Cost of Implementation, : The model used several system cost estimates. Based on cost data from the Santa Barbara County Data Exchange ($35,000-$55,000 per facility) authors estimated software costs for data exchange to be $20,000 per facility as software becomes standardized and nationally produced. The authors estimated costs to create software interfaces needed to exchange data as $15,000 per system for an easy integration (20% of cases), $45,000 per system for a moderately difficult integration (30% of cases) and $90,000 per system for a difficult integration (50% of cases)., Long-term Cost, : Annual yearly operating costs were estimated to be $27 billion per year to maintain system functionality and $21 billion per year to maintain the brokered peer-to-peer communication network.
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Description: DISCLAIMER, The studies referenced here were reported in peer-reviewed publications as systematic reviews, hypothesis tests, or predictive analyses. Although the results are valid for the institutions they represent, they may not be valid for otherorganizations with different technical capacities, project management expertise, organizational culture, or human and economic resources - all of which may affect cost. In addition, these studies may not contain the full technical details of how health information technology was implemented or how it operates. Thus, these results are best used as general guidelines for determining costs and benefits rather than as absolutes, because they may not hold true for all organizations. Please refer to Chapter 4 of "Costs and Benefits of Health Information Technology," AHRQ Publication No. 06-E006, for additional information on the limitations and conclusions of the studies included in the evidence report. I am in a four-person practice. What will the cost of an electronic medical record (EMR) implementation be for me? We are a small practice being asked to participate in a regional health information exchange. What are the pros and cons of doing this? What workflow and productivity changes can we expect? I want to implement computerized physician order entry (CPOE) in my hospital. What is the cost? What are the caveats? We are a small practice interested in improving care effectiveness by implementing an electronic health record (EHR) system. What does the research tell us on whether and how we can succeed? We've been asked to implement a computerized physician order entry (CPOE) CPOE system as part of a patient safety initiative. What can we really expect in terms of health benefits from CPOE? Question 3. I want to implement computerized physician order entry (CPOE) in my hospital. What is the cost? What are the caveats? Selecting CPOE and Hospital yields the following: NOTE: Below is an example screenshot of the search criteria you can use. Perform a search on the database . screenshot of the search criteria for Question 3 Article #4 is relevant. The following summary provides useful guidance on when an order entry system costs time., Settings, : Medical interns and surgical participated in this study, which took place in a tertiary-care hospital in Boston, Massachusetts., Intervention, : An Inpatient computerized physician order entry (CPOE)., Evaluation Method, : The measure of time spent ordering or in activities that might be simplified using order entry, and evaluation of specific types of ordering., Barriers, : Housestaff took twice as long writing orders using the CPOE. The authors suggested implementing strategies to reduce the writing time of one-time orders., Changes in Efficiency and Productivity, : For both medical and surgical house officers, writing orders on the computer took about twice as long (p < 0.001), or 44 minutes for medical and 73 minutes for surgical house officers. Medical house officers, but not surgeons, recovered about half this time because some administrative tasks ? such as looking for charts ? were made easier: 9.4-6.1% (p < 0.001), 27 minutes per day. Within types of orders, sets of stereotyped orders took much less time with order entry (3.1% before vs. 1.7% after), but one-time orders took longer (2.2% before vs. 7.2% after). The last article describes the effect on resource utilization:, Settings, : Six internal medicine wards within a public academic hospital, with all patients cared for by housestaff, fellows and faculty attendings., Intervention, : Computerization implementation., Evaluation Method, : Electronic data extracted from a set of networked microcomputers on which inpatient ordering occurred, the electronic health record (EHR) documentation system, and financial/billing system. Also some data presented were collected from a time-motion study and a user survey., Health IT System, : Regenstrief Medical Record System, which was developed in-house and supports writing of orders into computerized system., Health Care Utilization, : 12.7% reduction in total charges per admission for patients in the intervention group, with similar reduction in bed charges, test charges and medication charges. On average, the intervention group had a 0.89 per day reduction in length-of-stay compared with the control group., Changes in Efficiency and Productivity, : Intern physicians in the intervention group spent an average of 33 minutes/day longer writing orders (avg. 5.5 minutes/patient/day) Medications were filled sooner for both admitting orders (63 minutes) and daily drug orders (34 minutes) than for patients in the control group. Survey of the intervention group revealed than most felt that the accuracy of orders improved (75%). Fewer felt that their work was made faster (44%), but about half (52%) said that their work was made easier., Time Needed to Accrue Benefits, : Benefits demonstrated prospectively during 17-month study period. This article confirms that order entry takes longer on computer than on paper and highlights some benefits.