Health Affairs: Study puts a price tag on EMR implementation in small practices
 A study in this month’s edition of Health Affairs estimates the total first-year costs of EMR implementation for a five-physician practice to be $233,297, with average per-physician costs of $46,659.

Neil S. Fleming, vice president for healthcare research at the Institute for HealthCare Research and Improvement at Baylor HealthCare System in Dallas, and colleagues reported on the cost of implementing GE Healthcare’s Centricity EMR system in 26 primary care practices at HealthTexas Provider Network, a fee-for-service ambulatory care provider network affiliated with Baylor HealthCare System, taking into account hardware and software costs as well as the time and effort invested in implementation.

HealthTexas consists of more than 100 primary care, specialty care and senior health centers and more than 450 physicians in the Dallas-Fort Worth area. Data collection ranged from January 2004 to December 2009, with a focus on the 120 days before the launch of the EMR and the time after at each practice.

For an average five-physician practice, implementation costs through the first 60 days after EMR launch were an estimated $162,047, with an average per-physician cost of $32,409 and $85,500 in maintenance expenses during the first year.

“After maintenance costs for the whole first year after launch, we estimated the total costs through the first year to be $233,297, with average per physician costs of $46,659,” the authors wrote.

HealthTexas’ one-time infrastructure purchases amounted to $25,000 per practice for switches, cables and wireless internet connections, and approximately $7,000 per physician for personal computers, printers and scanners, according to the study.

“Maintenance costs--which began at implementation--amounted to approximately $14,700 per physician per year for software licensing, hosting and technical support (through a third-party vendor) and networking,” the authors stated. “The support provided by the network cost an additional $2,400 per year, yielding a total of approximately $17,100 per physician for maintenance.”

“We also estimate that the HealthTexas network implementation team and the practice implementation team needed 611 hours, on average, to prepare for and implement the EHR system, and that end users needed 134 hours per physician, on average, to prepare for use of the record system in clinical encounters,” the researchers wrote.

"Future research should also examine the impact of adoption on patient-centeredness, especially during the implementation period. Physicians’ satisfaction with EHR systems should be examined over time, because their opinions of a system will be critical components of its successful use,” the authors noted.

The research was funded by the Agency for Healthcare Research and Quality.