Study: Physician EHR-users not seeing return on investment

Although more physicians than ever are implementing electronic health records, many are not reaping a positive return on the investment, according to a new study in Health Affairs.

The researchers, from the University of Michigan and elsewhere, reviewed 49 physician practices in a large EHR pilot in Massachusetts--the Massachusetts eHealth Collaborative. The average physician lost nearly $44,000 over five years of implementing an EHR. Just over one-fourth (27 percent) of practices achieved a five year positive return on the investment. Only an additional 14 percent would come out ahead if Meaningful Use incentive payments also were factored in, the researchers determined.

The researchers found that the biggest challenge to a positive return on investment was the fact that the practices didn't change their operations to accommodate the change in record keeping. For instance, almost half of them didn't realize savings in part because they still also were using paper records. In addition, the practices that saw a financial benefit were those that used their EHRs to increase their revenue by better code capture, fewer billing errors and treatment of more patients in a day.

"Policies that provide additional support, such as expanding the regional extension center program, could help ensure that practices make the changes required to realize a positive return on investment from EHRs," the authors stated.

It should be noted that the MAeHC paid for the cost of each practice's system, and hired consultants to assist with implementation of those systems. The collaborative also helped practices with vendor selection and contract negotiations.

The researchers also cautioned against generalizing their results. "Although our sample included the most heterogeneous group of practices for which return-on-investment projections could be made, practices voluntarily adopted EHR systems by participating in the pilot and could thus be considered early adopters," they said.

Ironically, physicians also are encountering trouble in successfully attesting to Meaningful Use, with only 12.2 percent achieving that goal. Those receiving support from regional extension centers fared slightly better, with 15.9 percent of eligible physicians attaining Meaningful Use.

To learn more:
- read the study abstract