Is It Expensive?

In a word, yes. An equally important question is "Will it be worth the expense?" The expense of implementing a computer-based patient record will be proportional to the scale of the project. Costs can range from $25-$75,000 to tens of millions for a large, integrated delivery network comprised of multiple hospitals, physician practices, and specialty services. In other terms, the cost of this sort of application can run from about $1,500 per seat to $20,000 per seat depending the scale and combination of functions. The incremental costs of these systems (additional users, maintenance, upgrades, etc.) are usually considerably less. The complexity of acquiring a computer-based patient record system is also proportional to the scale of the project. In either case, the best decisions are usually based on a balance of cost and value.

Low-End/Office-Oriented Application

High-End/Enterprise Application

More patient throughput
Better and more accurate documentation
More complete billing/faster payment
Potentially better outcomes
Potential reduction of office staff
Cost/benefit can often be framed by comparing the cost of one or more FTEs.
Remember that the LAN technology involved can be complicated, and either someone will have to be trained or an outsider will need to be paid to help.
Support for automated results can propel the installation into the same technical league as an enterprise application.

Long term information store and outcomes data
Stronger cost management position when negotiating managed care contracts
Potentially better outcomes
Improved uniformity of care
Though you will hear otherwise, virtually no one has any meaningful cost/benefit data yet, so be prepared to measure yourself
More efficient use of physical space by reducing the amount of paper that needs to be stored for each patient. (Regulations associated with medical records can really limit this benefit.)

No matter what the scale of the implementation, a familiarity with such matters as relational databases and client server computing is indispensable. The key in spending the substantial amount of money involved is to somehow quantify the benefits and plan to measure.

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