Study: Implementing EHR, e-prescribing is challenging, but beneficial over time

Benefits from EHR and e-prescribing investments come under very broad, diverse categories but are very individual and specific to the retrospective context of an investment, according to a study by the European Commission. There is no single correct strategy for implementing EHRs and e-prescribing systems, yet the results of the study give grounds for optimism in the success, value and deployment of interoperable EHR and e-prescribing systems after a few years.

The European Commission investigated the qualitative socio-economic impact of interoperable EHR and e-prescribing systems in 11 practice cases in Europe, the U.S. and Israel to provide insight into factors surrounding successful EHR and e-prescribing deployment. Nine of the cases also underwent a quantitative evaluation of their socio-economic impacts.

“Decisions to invest in EHR and e-prescribing systems should [involve the adoption of] strategies that fit their local or regional setting and be designed to succeed by meeting clearly identified, measurable needs," concluded the Commission.

The socio-economic gain to society from interoperable EHR and e-prescribing systems eventually exceed the costs, according to the commision. While it found that a typical development can reach an annual socio-economic return (SER) of up to 400 percent, it can take at least four--and up to nine--years before initiatives produce their first positive annual SER.

According to the European Commission, it can take an average of nine years to realize a cumulative net benefit.  “Plans to invest in EHRs and e-prescribing systems should have a clear focus on achieving changes at the right time,” the commission reported. Longer time scales are generally associated with a lower risk of failure, according to the report.

In the study, the average distribution of costs were allocated from citizens (2 percent), providers (11 percent), health provider organizations (80 percent) and third parties (7 percent). The average distribution of benefits were dispursed between citizens (17 percent), providers (17 percent), health provider organizations (61 percent) and third parties (5 percent).

“From a systematic perspective, no single or small group of benefits comprise a sufficient reason for investment in EHR and e-prescribing systems,” the report found.

The total value of invested financial and non-financial resources at the evaluated sites was extremely wide with 42 percent of these expenditures on information and communication technologies.

According to the organization, an opportunity exists for all EHR and e-prescribing systems to facilitate a productive dialogue between users and information and communication technology experts before spending large sums of money on actual solutions. “Continouous engagement with healthcare professionals from the outset is essential and time-consuming, but must not be avoided,” stated the report. “If it is, it has bigger costs downstream.”

Another potential opportunity is to use interoperability as a prime driver of benefits. “Without the meaningful hearing and exchange of information, the gains would be marginal and not justify the cost of investments,” said the report.