Return on investment for a computerized physician order entry system.
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.


METHODS
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.


METHODS
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.


CONCLUSIONS
Other hospitals may be able to save money and improve patient safety by investing in CPOE systems.
Kaushal
Rainu
R
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Boston, MA 02120-1613, USA. rkaushal@partners.org
Jha
Ashish K
AK
Franz
Calvin
C
Glaser
John
J
Shetty
Kanaka D
KD
Jaggi
Tonushree
T
Middleton
Blackford
B
Kuperman
Gilad J
GJ
Khorasani
Ramin
R
Tanasijevic
Milenko
M
Bates
David W
DW
D000046:Academic Medical Centers; D001900:Boston; D002017:Budgets; D002201:Capital Expenditures; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D020000:Decision Support Systems, Clinical / Q000191:economics*; D016527:Drug Costs; D004363:Drug Utilization / Q000191:economics; D006801:Humans; D007449:Investments; D019300:Medical Errors / Q000191:economics / Q000517:prevention & control; D050316:Medical Order Entry Systems / Q000191:economics*