Hospitals may not be fully prepared for the full cost of EHR implementation, according to research published by Journal of the American Medical Informatics Association seeking to help organizations better understand the total bill.
Researchers from the United Kingdom and Boston identified four main cost categories: infrastructure (such as hardware and software); personnel (such as a project managers and training teams); facilities (furniture, fittings and space) and other (such as training materials).
"With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs," the authors said. Otherwise, health organizations risk failure.
The researchers evaluated the implementation of three centrally procured systems in 12 diverse healthcare organizations as part of England's £12.7 billion (USD $20 billion) National Programme for IT. They found myriad difficulties--the overall program was dismantled in September 2011 though component parts were kept in place, according to an announcement.
They studied organizations at different stages of implementing these systems and conducted 41 interviews with those involved.
Various factors affect the cost, they found, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff and different software applications to integrate with the new system.
Project planners tended to overlook certain costs. Training was the area where hospitals were most likely to scrimp--and one that could create new safety hazards, according to the authors.
Surveys continue to show physicians dissatisfied with the cost and functionality of EHR systems. Close to 70 percent of docs in a survey by Medical Economics published this week said the headaches haven't been worth it, 45 percent said that patient care has actually gotten worse following implementation of an EHR system and 43 percent said that they've incurred significant financial losses.
More than half in athenahealth's Physician Sentiment Index said the cost of EHR tools outweighs their benefit.
Those costs vary widely for community hospitals, with some paying less than $5 million and others more than $20 million, according to a survey from Community Hospital 100 and Anthelio.