title: Return on investment for a computerized physician order entry system.
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.
  
  
  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.
authors.affiliation: 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
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
authors.forename: Calvin
authors.initials: C
authors.lastname: Franz
authors.forename: John
authors.initials: J
authors.lastname: Glaser
authors.forename: Kanaka D
authors.initials: KD
authors.lastname: Shetty
authors.forename: Tonushree
authors.initials: T
authors.lastname: Jaggi
authors.forename: Blackford
authors.initials: B
authors.lastname: Middleton
authors.forename: Gilad J
authors.initials: GJ
authors.lastname: Kuperman
authors.forename: Ramin
authors.initials: R
authors.lastname: Khorasani
authors.forename: Milenko
authors.initials: M
authors.lastname: Tanasijevic
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: 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*