Return on Investment for a Computerized Physician Order Entry System
- Rainu Kaushal,
- Ashish K Jha,
- Calvin Franz,
- John Glaser,
- Kanaka D Shetty,
- Tonushree Jaggi,
- Blackford Middleton,
- Gilad J Kuperman,
- Ramin Khorasani,
- Milenko Tanasijevic,
- David W BatesBrigham and Women's Hospital CPOE Working Group
- Affiliations of the authors: Brigham and Women's Hospital and Harvard Medical School, Boston, MA (RK, AKJ, TJ, BM, RKh, MT, DWB); Department of Public Health, Weill Medical College of Cornell University, New York, NY (RK, GJK); Department of Health Policy and Management, Harvard School of Public Health, Boston, MA (AKJ); Eastern Research Group, Inc., Lexington, MA (CF); Department of Medicine, Columbia University Medical Center, New York, NY (KDS); Information Systems, Partners Healthcare System, Boston, MA (JG, BM, DWB)
- Correspondence and reprints: Rainu Kaushal, MD, MPH, Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120-1613; e-mail: <rkaushal{at}partners.org>
- Received 26 September 2005
- Accepted 1 February 2006
Abstract
Objective Although computerized physician order entry (CPOE) may decrease errors and improve quality, hospital adoption has been slow. The high costs and limited data on financial benefits of CPOE systems are a major barrier to adoption. The authors assessed the costs and financial benefits of the CPOE system at Brigham and Women's Hospital over ten years.
Design Cost and benefit estimates of a hospital CPOE system at Brigham and Women's Hospital (BWH), a 720-adult bed, tertiary care, academic hospital in Boston.
Measurements Institutional experts provided data about the costs of the CPOE system. Benefits were determined from published studies of the BWH CPOE system, interviews with hospital experts, and relevant internal documents. Net overall savings to the institution and operating budget savings were determined. All data are presented as value figures represented in 2002 dollars.
Results Between 1993 and 2002, the BWH spent $11.8 million to develop, implement, and operate CPOE. Over ten years, the system saved BWH $28.5 million for cumulative net savings of $16.7 million and net operating budget savings of $9.5 million given the institutional 80% prospective reimbursement rate. The CPOE system elements that resulted in the greatest cumulative savings were renal dosing guidance, nursing time utilization, specific drug guidance, and adverse drug event prevention. The CPOE system at BWH has resulted in substantial savings, including operating budget savings, to the institution over ten years.
Conclusion Other hospitals may be able to save money and improve patient safety by investing in CPOE systems.
Footnotes
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Most of the individual studies that were aggregated in this report were supported by the Agency for Healthcare Research and Quality, Rockville, MD.
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Members of the Brigham and Women's Hospital CPOE Working Group include Melissa Christino, William Churchill, Petr Jarolim, Joshua Peterson, Eric Poon, Jeffrey Rothschild, Cynthia Spurr, Carl Stapinski, Jonathan M. Teich, Debra Thomas, and Samuel Wang.
