The total cost of planning, buying, implementing and operating an electronic health record-system for the first year in a five-physician primary-care practice averaged $46,659 per physician, a federally funded team of Texas researchers has concluded.

A write-up of their research, "The Financial and Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices” appears in the March issue of the policy journal Health Affairs.

The EHR installations studied were in 26 family and internal-medicine practices that are part of HealthTexas Provider Network, a 450-physician fee-for-service care network affiliated with the Baylor Health Care System.

The cost per physician would probably be "not generalizable to small, isolated practices or to other practice settings," according to the researchers, given that the practices studied—even though they ranged in size from two to 12 physicians—were part of a large network.

"The network in our study may be considered a best-case scenario," the report's authors wrote. "Substantial corporate support was given to individual primary-care practices for the implementation of an electronic health-record system, thereby avoiding many of the perceived barriers to implementation." On the other hand, the authors said, "Our example could also be viewed as an excessive-case scenario, as more resources than necessary may have been provided by the HealthTexas network implementation team."

All installations in the study included a package of IT systems consisting of GE Healthcare's Centricity EHR, Clinical Content Consultants' advanced forms, and clinical messaging services and a document scanning and tracking system from Kryptiq.

Lead author Neil Fleming, vice president for healthcare research at the Baylor Health Care System, and his fellow researchers concluded that hard costs from one-time infrastructure purchases totaled $25,000 per practice for switches, cables and wireless Internet connections. Practices also paid around $7,000 per physician for personal computers, printers and scanners, he said, adding, "Maintenance costs, which began at implementation and included software licensing fees, hosting costs, technical support through a third-party vendor, networking and networking support costs, totaled about $17,100 per physician for the first year. " The study was funded by the Agency for Healthcare Research and Quality.