Cost of an informatics-based diabetes management program.
OBJECTIVE
The relatively high cost of information technology systems may be a barrier to hospitals thinking of adopting this technology. The experiences of early adopters may facilitate decision making for hospitals less able to risk their limited resources. This study identifies the costs to design, develop, implement, and operate an innovative informatics-based registry and disease management system (POPMAN) to manage type 2 diabetes in a primary care setting.


METHODS
The various cost components of POPMAN were systematically identified and collected.


RESULTS
POPMAN cost 450,000 dollars to develop and operate over 3.5 years (1999-2003). Approximately 250,000 dollars of these costs are one-time expenditures or sunk costs. Annual operating costs are expected to range from 90,000 dollars to 110,000 dollars translating to approximately 90 dollars per patient for a 1,200 patient registry.


CONCLUSIONS
The cost of POPMAN is comparable to the costs of other quality-improving interventions for patients with diabetes. Modifications to POPMAN for adaptation to other chronic diseases or to interface with new electronic medical record systems will require additional investment but should not be as high as initial development costs. POPMAN provides a means of tracking progress against negotiated quality targets, allowing hospitals to negotiate pay for performance incentives with insurers that may exceed the annual operating cost of POPMAN. As a result, the quality of care of patients with diabetes through use of POPMAN could be improved at a minimal net cost to hospitals.
Institute of Technology Assessment, Massachusetts General Hospital, Boston, MA 02124, USA. bblanchfield@partners.org
Bonnie B
BB
Blanchfield
Richard W
RW
Grant
Greg A
GA
Estey
Henry C
HC
Chueh
G Scott
GS
Gazelle
James B
JB
Meigs
D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D007256:Information Systems / Q000191:economics* / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000191:economics