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J Am Med Inform Assoc 19:423-438 doi:10.1136/amiajnl-2011-000310
  • Review

The economics of health information technology in medication management: a systematic review of economic evaluations

Editor's Choice
  1. K Ann McKibbon2
  1. 1Programs for Assessment of Technology in Health (PATH) Research Institute/St Joseph's Healthcare, Hamilton, Ontario, Canada
  2. 2Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
  3. 3Centre for Evaluation of Medicines, Hamilton, Ontario, Canada
  1. Correspondence to Dr Daria O'Reilly, Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, 25 Main Street West, Suite 2000, Hamilton, ON L8P 1H1, Canada; oreilld{at}mcmaster.ca
  • Received 11 April 2011
  • Accepted 7 September 2011
  • Published Online First 7 October 2011

Abstract

Objective To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process.

Materials and methods Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis.

Results The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations.

Discussion Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention.

Conclusion The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.

Footnotes

  • DO'R and J-ET hold Ontario Ministry of Health and Long-term Care Career Scientist 2 Awards.

  • Funding The major evidence report was funded by Agency for Healthcare Research and Quality, US Department of Health and Human Services, Contract No HHSA 290-2007-10060-I.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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