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Cited by 501Electronic Health Records SystemsTechnology and Human Factors in Education and HealthMedical Coding and Health Information

The DOI matches its Crossref record; 875 of the 877 references it cites were found in a registry or an index.

Costs and benefits of health information technology.

Open access
Shekelle, Paul G, Morton, Sally C, Keeler, Emmett B·2006
DOI 10.23970/ahrqepcerta132PMC PMC4781594
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Abstract

OBJECTIVES: An evidence report was prepared to assess the evidence base regarding benefits and costs of health information technology (HIT) systems, that is, the value of discrete HIT functions and systems in various healthcare settings, particularly those providing pediatric care. DATA SOURCES: PubMed, the Cochrane Controlled Clinical Trials Register, and the Cochrane Database of Reviews of Effectiveness (DARE) were electronically searched for articles published since 1995. Several reports prepared by private industry were also reviewed. REVIEW METHODS: Of 855 studies screened, 256 were included in the final analyses. These included systematic reviews, meta-analyses, studies that tested a hypothesis, and predictive analyses. Each article was reviewed independently by two reviewers; disagreement was resolved by consensus. RESULTS: Of the 256 studies, 156 concerned decision support, 84 assessed the electronic medical record, and 30 were about computerized physician order entry (categories are not mutually exclusive). One hundred twenty four of the studies assessed the effect of the HIT system in the outpatient or ambulatory setting; 82 assessed its use in the hospital or inpatient setting. Ninety-seven studies used a randomized design. There were 11 other controlled clinical trials, 33 studies using a pre-post design, and 20 studies using a time series. Another 17 were case studies with a concurrent control. Of the 211 hypothesis-testing studies, 82 contained at least some cost data. We identified no study or collection of studies, outside of those from a handful of HIT leaders, that would allow a reader to make a determination about the generalizable knowledge of the study's reported benefit. Beside these studies from HIT leaders, no other research assessed HIT systems that had comprehensive functionality and included data on costs, relevant information on organizational context and process change, and data on implementation. A small body of literature supports a role for HIT in improving the quality of pediatric care. Insufficient data were available on the costs or cost-effectiveness of implementing such systems. The ability of Electronic Health Records (EHRs) to improve the quality of care in ambulatory care settings was demonstrated in a small series of studies conducted at four sites (three U.S. medical centers and one in the Netherlands). The studies demonstrated improvements in provider performance when clinical information management and decision support tools were made available within an EHR system, particularly when the EHRs had the capacity to store data with high fidelity, to make those data readily accessible, and to help translate them into context-specific information that can empower providers in their work. Despite the heterogeneity in the analytic methods used, all cost-benefit analyses predicted substantial savings from EHR (and health care information exchange and interoperability) implementation: The quantifiable benefits are projected to outweigh the investment costs. However, the predicted time needed to break even varied from three to as many as 13 years. CONCLUSIONS: HIT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient. Some organizations have already realized major gains through the implementation of multifunctional, interoperable HIT systems built around an EHR. However, widespread implementation of HIT has been limited by a lack of generalizable knowledge about what types of HIT and implementation methods will improve care and manage costs for specific health organizations. The reporting of HIT development and implementation requires fuller descriptions of both the intervention and the organizational/economic environment in which it is implemented.

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Crossref · 10.23970/ahrqepcerta132

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Metadata

Authors
Shekelle, P. G., Morton, S. C., & Keeler, E. B.
ORCID
Shekelle, Paul G
Publisher
Agency for Healthcare Research and Quality
Published
2006-04
Issue
132
Pages
1-71
DOI
10.23970/ahrqepcerta132
PMC
PMC4781594
OpenAlex
W2169921538
Cited by
501
References
877
Citations by year
2026: 3 · 2025: 5 · 2024: 6 · 2023: 8 · 2022: 12 · 2021: 22 · 2020: 22 · 2019: 21 · 2018: 32 · 2017: 35 · 2016: 35 · 2015: 28 · 2014: 33 · 2013: 41 · 2012: 30
Type
report
Language
en
Open access
Locations
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Keywords
health information technology, electronic health records, clinical decision support, computerized physician order entry, pediatric care, outpatient care, inpatient care, quality of care, cost-effectiveness, implementation costs, process change, organizational context, cost-benefit analysis
MeSH terms
Ambulatory Care, Cost-Benefit Analysis, Costs and Cost Analysis, Information Systems, Pediatrics, Quality of Health Care, Technology, Medical Records Systems, Computerized

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