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35 pts.
 How do I figure out the cost comparison between EMR systems?
How do I figure out the cost comparison between EMR systems when they are quoted so differently? Some are subscription and some are licencing agreements.
ASKED: June 12, 2010  4:14 PM
UPDATED: June 23, 2010  9:32 am

Answer Wiki:
During the process of selecting an EHR, one critical step is to identify the TCO (Total cost of ownership). As you have mentioned, there are certainly different models that vendors would quote the EHR package. Some include hardware, and software costs upfront with reoccurring maintenance fees, others are simply a monthly subscription fee. In most cases, you will need to establish what the system will cost you over a period of five years. This analysis not only will help you identify which package will have an ROI, but also discover many of the hidden costs that usually are identified during the implementation or even several months post going live. Some of the costs to identify are: Third party technology vendors to assist with the additional day to day support needed (if IT is outsourced). Connectivity monthly costs (cost of faster / dedicated connectivity when using an ASP model) Maintenance fees and warrantee upgrades on hardware after 3 years Licenses costs of third party applications (example: Microsoft Office, Database engine licenses, crystal reports, and so forth) Fees associated with yearly maintenance fees on the EHR and other packages (eFax/Clearinghouse/web portal for patients..) Charts scanning services to capture paper charts costs of lists updates (CPTs/ICD 9/Formulary..) There are several resources online that can assist review and price all the needed items for you. The end result would be a detailed analysis of all the different models you were quoted. This will enable you to have a better overview of what type of investment you will need to make in each solution.
Last Wiki Answer Submitted:  June 15, 2010  2:08 am  by  RedaChouffani   1,785 pts.
All Answer Wiki Contributors:  RedaChouffani   1,785 pts.
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Identifying the Total Cost of Ownership is the best approach. The TCO covers the total cost of acquiring and operating the EHR over its expected lifetime. An expected lifetime of five years is a reasonable estimate. A good basic discussion of TCO may be found at
In cases involving payments spread over time such as subscription fees and annual maintenance fees, I would use a discounted cash flow analysis to compare the various choices. A discussion of discounted cash flow analysis may be found at

 385 pts.

 

Identifying the Total Cost of Ownership is the best approach. The TCO covers the total cost of acquiring and operating the EHR over its expected lifetime. An expected lifetime of five years is a reasonable estimate. A good basic discussion of TCO may be found here. In cases involving payments spread over time such as subscription fees and annual maintenance fees, I would use a discounted cash flow analysis to compare the various choices. A discussion of discounted cash flow analysis may be found here.

 385 pts.

 

I will suggest not to focus on just the cost factor. There are vendors, who would give the software at through away prices; as they are going to be dead anyways soon.

Apart from cost, look for certifications and integration capabilities they have. In case you are focusing on just the cost, yes you can use any of the financial tools.

On a lower risk side, you can try something on a host / ASP / SaaS based model for few months and see which one fits you the best. It is easier to switch vendors on these kinds of models, in case you find the pain points of integrating with other application. It’s worth to just spend few thousand dollars on trying and choosing the best rather than loosing everything or spending your precious time fixing stuff.

On a personal note, if you are not sure – never go with onetime fee setups.

Thanks
Niran

 200 pts.

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