Abstract
BackgroundResearch regarding return on investment for electronic health records (EHRs) is sparse.ObjectiveTo extend previously established research and examine rigorously whether increasing the adoption of computer-based provider/prescriber order entry (CPOE) leads...
Highlights
Literature reviewConcerns and changes in healthcare continue toward increased financial constraints, scarce resources and expanding regulatory requirements.[1,2,3,4,5,6] Healthcare delivery organisations deal with substantial pressures to reduce costs and improve capacity efficiencies, often summarised through emphasis on length of stay (LOS), among other signs and indicators of improved delivery performance
The current study explored the impact on LOS once computer-based provider/prescriber order entry (CPOE) adoption reached high levels and stabilised at a plateau
Analyses confirmed that CPOE adoption and LOS changed significantly over the first 66 months of data analysed and that they were significantly and inversely correlated (Figure 1)
Summary
Literature reviewConcerns and changes in healthcare continue toward increased financial constraints, scarce resources and expanding regulatory requirements.[1,2,3,4,5,6] Healthcare delivery organisations deal with substantial pressures to reduce costs and improve capacity efficiencies, often summarised through emphasis on length of stay (LOS), among other signs and indicators of improved delivery performance. The question of our community-focused healthcare organisation became whether our EPR implementation, incorporating proven computerised provider order entry (CPOE), would favorably affect LOS.[8,9,10,11] Shorter lengths of stay are beneficial for payers, who reimburse hospitals on a per diem basis; for patients, who get home faster; and for hospitals, whose costs are lower; but for physicians paid on a fee-for-service basis, achieving shorter LOS is a perverse incentive. Objective To extend previously established research and examine rigorously whether increasing the adoption of computer-based provider/prescriber order entry (CPOE) leads to a decrease in length of stay (LOS), and to demonstrate that the two are inversely and bidirectionally proportional even while other efforts to decrease LOS are in place. CPOE appeared statistically to be an independent factor in affecting LOS, over and above other efforts to shorten LOS, contributing to lower costs and improved efficiency outcomes as measured by LOS, even as CMI rises
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