title: Health IT-assisted population-based preventive cancer screening: a cost analysis.
abstract: OBJECTIVE
  Novel health information technology (IT)-based strategies harnessing patient registry data seek to improve care at a population level. We analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network.
  
  
  METHODS
  Monte Carlo simulations were used to compare costs across management strategies.
  
  
  METHODS
  We assessed the cost of the software, materials, and personnel for baseline usual care (BUC) compared with augmented usual care (AUC [ie, automated patient outreach]) and augmented usual care with physician input (AUCPI [ie, outreach mediated by physicians' knowledge of their patient panels]) over 1 year.
  
  
  RESULTS
  AUC and AUCPI each reduced the time physicians spent on cancer screening by 6.5 minutes per half-day clinical session compared with BUC without changing cancer screening rates. Assuming the value of this time accrues to the network, total costs of cancer screening efforts over the study year were $3.83 million for AUC, $3.88 million for AUCPI, and $4.10 million for BUC. AUC was cost-saving relative to BUC in 87.1% of simulations. AUCPI was cost-saving relative to BUC in 82.5% of simulations. Ongoing per patient costs were lower for both AUC ($35.63) and AUCPI ($35.58) relative to BUC ($39.51).
  
  
  CONCLUSIONS
  Over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions. Primary care networks considering similar interventions will need to capture adequate physician time savings to offset the costs of expanding IT infrastructure.
authors.affiliation: Massachusetts General Hospital, 50 Staniford St, 9th fl, Boston, MA 02114. E-mail: dlevy3@mgh.harvard.edu.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Levy
authors.forename: Vidit N
authors.initials: VN
authors.lastname: Munshi
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Ashburner
authors.forename: Adrian H
authors.initials: AH
authors.lastname: Zai
authors.forename: Richard W
authors.initials: RW
authors.lastname: Grant
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Atlas
mesh_terms: D003365:Costs and Cost Analysis; D055088:Early Detection of Cancer / Q000191:economics*; D006801:Humans; D008490:Medical Informatics / Q000191:economics*; D009010:Monte Carlo Method; D010818:Practice Patterns, Physicians' / Q000191:economics; D011320:Primary Health Care; D014481:United States; D016526:Workload