Electronic Health Records

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Advanced EHR Use Shows Potential to Lower Patient Costs

Research shows that patients at advanced EHR use hospitals cost on average $730 less than those at other hospitals.

By Sara Heath

- Advanced EHR use may lead to significant per patient savings, showing promise for an eventual return on investment, shows a study published in the American Journal of Managed Care.


The study included a retrospective analysis of the National Inpatient Sample (NIS) and the HIMSS Annual Survey to examine patient costs and rates of advanced EHR use.

For the purposes of the study, the researchers defined advanced EHR use as meaningful use. Those that achieved the benchmarks set forth by the Centers for Medicare and Medicaid Services’ EHR Incentive Programs were categorized as advanced EHR users.

“Such criteria for use are based on previous studies that report improvements in quality,” the researchers explained.

“To qualify as a meaningful user and benefit from the related incentives, EHR systems must include electronic prescribing, health information exchange with other providers, automated reporting of quality data, electronic recording of patients’ history (demographics, vital signs, medication and diagnosis lists, and smoking status), created care summary documents, and at least 1 clinical decision support tool.”

After examining the data, the research team identified 550 hospitals for their study, with 104 of them categorized as advanced EHR users.

On average, those 104 hospitals saw a notable drop in per patient costs, with each patient costing $731, or 9.66 percent less than patients treated at other hospitals. Those results take into account patient- and hospital-specific variables.

According to the researchers, such cost savings may be credited to the increased efficiency advanced EHR use may bring.

“Meaningful use requirements are believed to improve the legibility of records, reduce prescription errors, improve adherence to best clinical practice guidelines, improve patient and clinician access to records, and allow exchange of health information,” the research team said. “In addition to gains in quality, EHRs have been predicted to save $81 billion annually through safety improvement and increased efficiency of care.”

Despite these results, the researchers recognize that not all EHR users are seeing cost savings, or return on investment. This may be because they are not utilizing all of the EHR features necessary to deliver cost-efficient care.

“The staging model that was used demonstrates that cost savings may not be realized until multiple features are included and implemented,” the researchers explained. “Since EHR systems are complex and costly to implement, it is often a multistage process to adopt and use EHRs.”

“Thus, hospitals must anticipate that the financial savings may not exist until advanced, ‘meaningful’ use is attained,” they continued. “The majority of hospitals have yet to reach the stage of implementation where cost savings are possible, since they are not using advanced EHRs.”

The team also acknowledged the significant up-front costs associated with advanced EHR use, recognizing that an initial EHR implementation can run hospitals hundreds of thousands of dollars.

That all said, this data can be used to help build the business case for EHR adoption.

“These cost savings will benefit many third-party payers, hospitals, and patients, and incentives such as those provided through the HITECH Act to promote EHR adoption and use will benefit hospitals,” the research team concluded.

“Since many previous studies have shown that EHRs can improve the safety and quality of care in hospitals, the projected cost savings in this study provides additional motivation and builds the business case for hospitals to make the large investment in adopting and maintaining an EHR system.”

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