Electronic Health Records

Adoption & Implementation News

Lessons from Canada: $1.3 billion in long term EHR benefits

By Jennifer Bresnick

- A new PricewaterhouseCoopers (PwC) study commissioned by Canada Health Infoway, our northern neighbor’s equivalent of the ONC, reveals some encouraging news for EHR adopters who aren’t sure when or if they will see a return on investment (ROI) for their pricy EHR systems.  The survey looks at providers and hospitals that adopted EHRs as early as 2006, and finds that more than $1.3 billion has been saved in administrative efficiencies, reduced adverse events and duplicate testing, and improved chronic disease management for patients.

These are the promises that US providers have heard since the beginning of the EHR Incentive programs, and yet many haven’t been able to find their way out of a quagmire of burdensome expenses, technical problems, workflow frustrations, and productivity losses.  National Coordinator Dr. Farzad Mostashari recently urged patience for those who haven’t found a reason to be thrilled with their EHR adoption, and the new Canadian survey may prove that there is merit to his assertion.

“In some cases, it’s the sum of a lot of little things,” said Jennifer Zelmer, senior vice-president with Canada Health Infoway. “When you’re using electronic medical records, staff in a medical practice tend to spend less time pulling charts, and they’re able to use that time for clinical services.  And when you add up those kinds of efficiencies, both in terms of chart pulls and in terms of tracking down test results, actually the value of that is quite significant.”  The survey found that financial savings from administrative streamlining jumped significantly after about four years of EHR use, a finding that is consistent with predictions about the maturity period required for physicians to see ROI.  Chart pull reductions are estimated to have saved $177 million in 2012 alone.

The decline in test duplication also shot upward after four years, reaching an annual saving of $99 million in 2012.  When an EHR prominently displays a prior test result in a patient’s chart, it makes it easier for nurses and physicians to spot before ordering new labs.  “This benefit is likely to be substantially enhanced as decision support is optimized and focused, and when there is more integration between EHRs and other systems external to the community-based care setting,” the report predicts.  Since implementing EHRs, 94% of physicians report their patients receive their test results faster and 97% say that they have been able to stop unnecessary repetitions of blood draws and other tests.

The benefits extent directly to patients in other ways, as well.  Eighty-six percent of patients are likely to say that their doctor always knows what’s important about their health when they look up information in an EHR, and 96% of physicians report they are more up to date and better able to coordinate their patients’ continuum of care with access to EHR information.

While there are certainly differences in the two healthcare systems that might account for the disparity between United States and Canadian satisfaction and savings, it’s important to see that concrete benefits can be achieved through health IT adoption and EHRs.  “EHRs are transformative in nature,” the report concludes.  “They fundamentally change the work, productivity, and processes in community-based practices and facilitate enhanced delivery of care.”  The United States has been continually working towards realizing the full potential of EHRs, and can take heart that with several years and some of Mostashari’s patience, American providers may be boasting similar savings and accomplishments.



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