Here at Clinica, all the cost analysis we do tells us it is going to be very expensive to migrate to electronic medical records. We can see our net costs will increase and that will be true for every clinic like ours, I believe.
Our drivers are: 1) A strong desire to capture clinical data to a) make data driven, timely and informed decisions as leaders; 2) Measure clinical data to assess (and improve) our outcomes in the areas of chronic disease, prevention, and clinical guideline use. 3) Change our clinical paradigm from an acute care model to a dual model that includes open access for acute visits and episodic planned care visits, individualized by patient diagnosis and demographic information (age, sex, primarily, although race is becoming important for certain diseases). 4) Maintain disease registries that capture the clinical measures and guidelines for that group of patients and to assist in identifying patients that need services, but are not coming in. The idea is to take responsibility for the health status of our service area, not just the patients that are coming in, by providing outreach to those that are not. 5) Capture accurate clinical data to provide provider quality incentives 6) Prepare for the future, as this data will become more and more important as the payers move to a p4p model. 7) Provide point of care guidelines and clinical tools for providers. 8) Provide point of service error-check functions for providers. Of course, we are looking at cost, but abandoned the idea that we can make the business case based upon the numbers. On the other hand, the clinical case is impossible to ignore; and since we our business is our patients, the clinical case is the business case. To me, the appropriate use of medical software in the clinical setting is just as essential as aspirin in heart attacks and Insulin in Type I DM. It saves lives and improves outcomes. No one argues about whether we need medications or not, just how to get them to patients in a cost-effective way. So the question becomes not if we can afford it, but how we can afford and implement it to meet the parameters outlined above. I don't attempt to quantify the benefits because when you take that approach, the discussions over process always obfuscate the real issues about patient safety and clinical quality. For us, the discussion is about what we need to do in order to afford it. Matt King MD Medical Director, Clinica Adelante, Inc -----Original Message----- From: Suchi Pande [mailto:[EMAIL PROTECTED] Sent: Tuesday, September 20, 2005 9:05 PM To: hardhats-members@lists.sourceforge.net Subject: Re: [Hardhats-members] Computer World Editorial on Network Effect Nancy Anthracite wrote: > You are so right. You might be able to stick a dollar amount on money saved > on maintaining and finding paper records, but how can you put a dollar amount > on having a machine double check your orders for drug interactions, always > having that chart at your fingertips, etc. > > "Priceless" for an answer probably won't hack it. > Well.. No doubt evaluating it is tricky, but getting a ball park figure is not impossible and is what will persuade. In the case you mention: dollar amount saved for automating health records = (paper costs saved) + (Time saved in seconds * salary/ per second of worker) + (mistreatment costs saved per patient) where: (mistreatment costs saved per patient) = (mistreatment costs per patient) * (pre-automation - post-automation mistreatment rate per patient ) where (mistreatment costs saved per patient) = money lost by patient + money lost by hospital in fixing problem + any compensation for mental trauma etc... (ie needs further breaking down, but you get the general principle. If in doubt, get a medical physicist down in radiology to help you with thinking this thing through - physicists tend have a way of looking at these kind of problems that engineers and programmers don't). Christoph was trying to figure out how to quantify the benefits. Well, show a boss the figures that come out with this kind of reasoning. He will leap upon them, dress them up in a powerpoint presentation, and call it a Cost-Benefit-Analysis and get on with persuading management to do a switch to EHR. IIRC, the VA had quantified the reduction in wrong drugs given pre and post VISTA. So I am sure the information is out there. regards PJ ------------------------------------------------------- SF.Net email is sponsored by: Tame your development challenges with Apache's Geronimo App Server. Download it for free - -and be entered to win a 42" plasma tv or your very own Sony(tm)PSP. Click here to play: http://sourceforge.net/geronimo.php _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members ------------------------------------------------------- SF.Net email is sponsored by: Tame your development challenges with Apache's Geronimo App Server. Download it for free - -and be entered to win a 42" plasma tv or your very own Sony(tm)PSP. Click here to play: http://sourceforge.net/geronimo.php _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
