Costs associated with developing and implementing a computerized clinical decision support system for medication dosing for patients with renal insufficiency in the long-term care setting.
A team of physicians, pharmacists, and informatics professionals developed a CDSS added to a commercial electronic medical record system to provide prescribers with patient-specific maximum dosing recommendations based on renal function. We tracked the time spent by team members and used US national averages of relevant hourly wages to estimate costs. The team required 924.5 hours and $48,668.57 in estimated costs to develop 94 alerts for 62 drugs. The most time intensive phase of the project was preparing the contents of the CDSS (482.25 hours, $27,455.61). Physicians were the team members with the highest time commitment (414.25 hours, $25,902.04). Estimates under alternative scenarios found lower total cost estimates with the existence of a valid renal dosing database ($34,200.71) or an existing decision support add-on for renal dosing ($23,694.51). Development of a CDSS for a commercial computerized prescriber order entry system requires extensive commitment of personnel, particularly among clinical staff.
Field
Terry S
TS
Meyers Primary Care Institute, 630 Plantation Street, Worcester, MA 01605, USA. terry.field@umassmed.edu
Rochon
Paula
P
Lee
Monica
M
Gavendo
Linda
L
Subramanian
Sujha
S
Hoover
Sonia
S
Baril
Joann
J
Gurwitz
Jerry
J
D003365:Costs and Cost Analysis; D020000:Decision Support Systems, Clinical / Q000191:economics*; D004360:Drug Therapy, Computer-Assisted / Q000191:economics*; D006282:Health Personnel / Q000191:economics*; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D050316:Medical Order Entry Systems / Q000191:economics*; D016347:Medical Records Systems, Computerized; D008509:Medication Systems / Q000191:economics; D009936:Organizational Innovation / Q000191:economics; D051437:Renal Insufficiency / Q000188:drug therapy* / Q000191:economics; D013647:Task Performance and Analysis; D014584:User-Computer Interface