A new study on an interoperable national healthcare information technology system shows that costs remain the biggest barrier to fulfilling President Bush's dream of a paperless system within a decade. The study looked at the cost of establishing a national network within five years. Though the study doesn't identify who will pay what, study authors and sponsors say they will work to find the money.
"I don't think we're going to get there without some large, upfront investment," said lead study author Rainu Kaushal, M.D., an internist and pediatrician as well as the project leader at the Center for Excellence for Patient Safety Research and Practice at Brigham and Women's Hospital, Boston.
The team of top researchers found that connecting major healthcare providers through a fully functioning national health IT network would quadruple current spending levels. They estimated five-year capital costs of $156 billion and operating costs of $48 billion, or a little less than $10 billion annually.
In the Aug. 2 issue of the Annals of Internal Medicine, researchers from Brigham and Women's Hospital, Harvard University School of Medicine and other institutions subdivided proposed spending on the national IT network into money that will set up centralized regional health information organizations, or RHIOs, which will be needed to connect providers, and money to pay for the purchase and operations of seven essential provider-based IT systems.
Over the five-year period a national system of RHIOs would require $53 billion in capital costs and $21 billion for operations to connect the healthcare organizations covered by the most recent study. Setting up all providers with the seven key IT systems would account for the remainder of the total estimated IT costs, or $103 billion in capital costs and $27 billion in operating expenses. Electronic medical-record systems would be the most expensive system -- a $62.4 billion price tag for capital costs and $15.6 billion in operating costs.
Hospitals would pay the bulk of the EMR tab: nearly $36.4 billion for capital and $8.1 billion for operating costs. Physician office practices would pay $13 billion to buy and install EMR systems and nearly $3.8 billion to run them.