The document describes a financial impact tool called FIT for EMR that was developed by Vertex Healthcare Consulting to help healthcare organizations measure the financial benefits of implementing an electronic medical records (EMR) system. The tool calculates four key financial metrics - project break-even point, net present value, return on investment over 5 years, and internal rate of return. It also produces a 5-year financial pro forma. The tool was created using a four-step process of defining financial terms, developing costs and benefits line items, and applying financial modeling adjustments to represent costs and benefits over time.
The document discusses injury and illness prevention programs (IIPPs), which are proactive processes that help employers identify and fix workplace hazards before workers get hurt. The key is management leadership, worker participation, hazard identification and control, training, and program evaluation. Studies show IIPPs can dramatically reduce injuries and illnesses, lower costs from insurance and lost productivity, and improve workplace culture. They are required in many countries and 34 US states due to their effectiveness.
Cartdiff School of Certified Professional provide NEBOSH general certificate in Lahore, Pakistan. CSCP-global has professional tutors for NEBOSH National General Certificate in Occupational Health and Safety. for books visit
http://www.cscp-global.com/resources.php
This GAO report summarizes the findings of case studies conducted at five companies that had implemented ergonomics programs. The case studies found that effective ergonomics programs include six core elements: management commitment, employee involvement, identifying problematic jobs, developing solutions to ergonomic hazards, training and education, and medical management. While the studied companies incorporated these elements, they did so in varied ways based on their industry and culture. The report found that the ergonomics programs yielded benefits like reduced workers' compensation costs and injuries, though measuring overall performance was complicated. The experiences suggest positive results can be achieved through a simple, informal, site-specific approach to implementing ergonomics programs.
Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR
Presentation Makes the Case for Enterprise Risk ManagementPYA, P.C.
This document outlines a presentation on enterprise risk management (ERM) given to Massachusetts Continuing Legal Education, Inc. It discusses how ERM began with the Committee of Sponsoring Organizations of the Treadway Commission to help organizations assess internal controls. It describes how ERM was initially implemented in the financial sector but is now used more widely across industries. The presentation explains the traditional silo structure of risk management in healthcare and payers and how ERM provides a more holistic and strategic approach to managing enterprise-wide risks.
Onboarding Compliance in the Healthcare Professional EnvironmentEquifax
Healthcare is easily one of the most tightly regulated industries in the US and without a targeted onboarding compliance strategy in place for your Health Care Professional hires (HCP), you could be exposing your organization to significant risks.
This document discusses the underutilization of captives for financing employee benefit risks and the opportunities they present. Some key points:
- Only 2.8% of captives include employee benefit risk lines, accounting for just 0.9% of total captive premium.
- EU companies are ahead of US companies in introducing employee benefits to captives, likely due to greater experience with similar structures.
- Challenges include the labor intensive nature of organizing employee benefits, higher administrative costs compared to property & casualty lines, and regulatory hurdles.
- However, interest is growing due to challenges of managing increasingly complex global employee benefits and high medical costs, particularly in emerging markets. Captives can help
The document outlines the Office of Inspector General's (OIG) focus areas for auditing Medicare compliance, including reviewing physicians and suppliers for incorrectly billed amounts, high cumulative payments, physician-owned distributors of spinal implants, place-of-service coding errors, and use of incident-to billing. It then discusses the seven key elements of an effective compliance plan according to OIG: having policies and procedures, designating a compliance officer, conducting training, effective communication, internal monitoring, enforcement, and responding to issues. The presentation emphasizes establishing a culture of compliance, keeping plans up-to-date, ongoing training, investigating reports, and conducting audits.
The document discusses injury and illness prevention programs (IIPPs), which are proactive processes that help employers identify and fix workplace hazards before workers get hurt. The key is management leadership, worker participation, hazard identification and control, training, and program evaluation. Studies show IIPPs can dramatically reduce injuries and illnesses, lower costs from insurance and lost productivity, and improve workplace culture. They are required in many countries and 34 US states due to their effectiveness.
Cartdiff School of Certified Professional provide NEBOSH general certificate in Lahore, Pakistan. CSCP-global has professional tutors for NEBOSH National General Certificate in Occupational Health and Safety. for books visit
http://www.cscp-global.com/resources.php
This GAO report summarizes the findings of case studies conducted at five companies that had implemented ergonomics programs. The case studies found that effective ergonomics programs include six core elements: management commitment, employee involvement, identifying problematic jobs, developing solutions to ergonomic hazards, training and education, and medical management. While the studied companies incorporated these elements, they did so in varied ways based on their industry and culture. The report found that the ergonomics programs yielded benefits like reduced workers' compensation costs and injuries, though measuring overall performance was complicated. The experiences suggest positive results can be achieved through a simple, informal, site-specific approach to implementing ergonomics programs.
Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR
Presentation Makes the Case for Enterprise Risk ManagementPYA, P.C.
This document outlines a presentation on enterprise risk management (ERM) given to Massachusetts Continuing Legal Education, Inc. It discusses how ERM began with the Committee of Sponsoring Organizations of the Treadway Commission to help organizations assess internal controls. It describes how ERM was initially implemented in the financial sector but is now used more widely across industries. The presentation explains the traditional silo structure of risk management in healthcare and payers and how ERM provides a more holistic and strategic approach to managing enterprise-wide risks.
Onboarding Compliance in the Healthcare Professional EnvironmentEquifax
Healthcare is easily one of the most tightly regulated industries in the US and without a targeted onboarding compliance strategy in place for your Health Care Professional hires (HCP), you could be exposing your organization to significant risks.
This document discusses the underutilization of captives for financing employee benefit risks and the opportunities they present. Some key points:
- Only 2.8% of captives include employee benefit risk lines, accounting for just 0.9% of total captive premium.
- EU companies are ahead of US companies in introducing employee benefits to captives, likely due to greater experience with similar structures.
- Challenges include the labor intensive nature of organizing employee benefits, higher administrative costs compared to property & casualty lines, and regulatory hurdles.
- However, interest is growing due to challenges of managing increasingly complex global employee benefits and high medical costs, particularly in emerging markets. Captives can help
The document outlines the Office of Inspector General's (OIG) focus areas for auditing Medicare compliance, including reviewing physicians and suppliers for incorrectly billed amounts, high cumulative payments, physician-owned distributors of spinal implants, place-of-service coding errors, and use of incident-to billing. It then discusses the seven key elements of an effective compliance plan according to OIG: having policies and procedures, designating a compliance officer, conducting training, effective communication, internal monitoring, enforcement, and responding to issues. The presentation emphasizes establishing a culture of compliance, keeping plans up-to-date, ongoing training, investigating reports, and conducting audits.
Health risks @ Electro Magnetic Radiation white paper & solution documentBrightsandz Technologies
You may address it as ElectroMagnetic Radiation or Microwave Radiation or ElectroSmog. One way or the other, man made sources of radiation may the most significant pollution that human activity has produced in this century. All the more because it is intangible, invisible and insensible.
This paper addresses the issue of electromagnetic radiation (EMR), while seeking to separate the fact and the myth about EMR.
It connects through a variety of relevant topics such as source of EMR and the effect of EMR on birds, animals, bats, bees; to the microwaving effect on human tissue and the key risks associated.We have covered the inadequate standards and the legislation and relevant case studies.
paper_Measuring the Efficiency and Productivity Change of APEC Mobile Telecom...Nicky Chao
The document analyzes the efficiency and productivity change of 28 mobile telecommunications operators in APEC countries from 2003 to 2008. It finds that productivity increased by 5.5% over this period, primarily due to improvements in technical efficiency rather than innovation. Specifically, it used data envelopment analysis and Malmquist index approaches to measure efficiency based on operating revenue, subscribers, employees, assets, and capital expenditures. The most efficient operators were KDDI, Telkomsel, and Smart Communication, while others like Verizon Wireless and AT&T had technical efficiency below 0.6 on average.
The document discusses methods for measuring performance and clinical outcomes in healthcare. It describes the major domains of patient safety measurement as harm, mortality, infections, readmissions, patient satisfaction, and safety culture. It then focuses on defining medical errors and adverse events, and explaining why measurement is important for evaluating current systems and improving outcomes. Different methods of data collection are outlined, including direct observation, cohort studies, record review, and incident reporting systems. The Global Trigger Tool for assessing harm using chart review is also summarized.
Supply Chain Metrics That Matter: A Focus on Hospitals - 6 JAN 2013Lora Cecere
Executive Overview
Growth is slowing. Profitability is tougher. Compliance mandates are growing. How do companies balance the goals for value-based outcomes for health and wellness with costs? In this environment, supply chain matters more than ever.
In this report, we share insights on healthcare supply chains. Grown out of the offices of procurement, the supply chain function of the hospital is still in its infancy; but based on increasing business requirements and complexity, it is only beginning to show its true potential.
Growth: Futures are Uncertain.
The hospital administrator is facing many challenges. Growth is slowing and pressures are growing. The question is how to balance patient outcomes with better cost management. How does a hospital move forward with an uncertain future? And, what will be the impact of healthcare reform?
In table 1, we list top line growth over the past decade for four companies operating within the hospital industry. While there are ups and downs, the general trend is downward.
Healthcare Service delivery efficiency; performance of gauteng hospitalsOliver Nwauka
There is a general perception that public healthcare service delivery is deteriorating severely, despite government commitments to change this. This dysfunction stems from the cumulative impact of burden of diseases, economic pressures, population surge, policy and strategy incoherence and managerial incompetence. The core objective of this qualitative research study therefore, is to gain insight into the cause-effects of this sub-minimal performance, patients’ dissatisfaction and the waste of resources in Gauteng’s public healthcare sectors, with an intention to provide recommendations in resolving this crisis and to further this research.
This research made use of Performance Assessment Tools for quality improvement in Hospitals (PATH) framework and Data Envelopment Analysis (DEA) to evaluate the satisfaction levels, performance and technical efficiencies of public hospitals, which were compared to the private sector.
The findings agree that the satisfaction of patients is poor, performance sub-minimal and technically inefficient and health outcomes unsatisfactory relative to private hospitals. Patients’ dissatisfaction level was 76%. The efficiency constant returns to scale (CRS) were (40%), (63%) and (100%) respectively for district, regional and private hospitals while their variable returns to scale (VRS) were 60%, 37% and 100% with scale efficiency score of 92%, 52% and 100 % in that order. Health outcomes such as patients re-admission within a 28-day period recorded 20%, 21%, <5% for the district, regional and private hospitals respectively, and PHC health outcome (25%).
The lack of patient satisfaction, performance slack and inefficiency resulted partly from overall poor decision-making abilities on the use and allocation of resources and the lack of integrated information systems in the facilities
This document discusses various topics related to health care management and patient satisfaction. It addresses how to delight patients, provide quality service, and handle complaints effectively. It emphasizes treating the patient as the most important person and focusing on their experience. Specific tips are provided for dealing with angry patients and common patient complaints. The importance of seeing things from the patient's perspective is highlighted. Overall, the document stresses prioritizing excellent patient care, communication and satisfaction.
The insights driving superior healthcare outcomes in Asia Pacific.
Asia-Pacific Insight Magazine brings together IMS Health experts from across the region, delivering fresh perspectives on how to navigate through the challenges and opportunities in Asia-Pacific pharmaceutical market.
This Discussion offers you the opportunity to apply return on in.docxgasciognecaren
This Discussion offers you the opportunity to apply return on investment (ROI) concepts in a real case scenario. As is often the case, technology offerings involve costs that must be justified by virtue of expense reductions for revenue increases in the organization. There are creative opportunities in the Discussion for leaders to facilitate the development of the revenues into the organization and operational changes that reduce expenses.
Scenario:
Dynamic Health System is a 3-hospital, 500-bed system in the Midwest United States. This system employs 100 physicians, both primary care and specialists, in 12 physician practices. Dynamic also runs a center of excellence in orthopedic care for the large geriatric population in the area, including an outpatient rehabilitation facility that is currently profitable. Dynamic offers a full spectrum of medical and surgical services to their population with an emphasis on programs of excellence in orthopedic surgery, diabetes, and women’s care.
Dynamic’s typical patient mix is over 45% Medicare with another 35% private pay patients covered by three large insurance companies. Their Medicaid population is approximately 12%, with the reminder of patients self-pay.
Due to market forces, the three private payers have begun to implement a program of bundled payments for their members in the following areas: hip replacements, knee replacements, and lower back surgeries. In these models, Dynamic hospitals and employed physicians will be paid a fixed amount for an entire episode of care from pre- surgery evaluation, through surgery and post-surgery, physical therapy, and rehabilitation. Medicare is likewise proposing a pilot study for a population of hip replacement beneficiaries to assess the outcomes of care as opposed to procedure costs as a result of Dynamic’s petition to receive increased payments for beneficiaries due to age demographics and for being the only orthopedic geriatric center in 200 miles.
As a result of these factors and the aging HIT infrastructure, the Chief Medical Officer (CMO), Chief Executive Officer (CEO), and Chief Information Officer (CIO) of Dynamic are proposing the purchase of a monolithic Electronic Health Record (EMR) solution that will provide complete online documentation, orders, pharmacy, labs, and patient portal for all hospitals and employed physician offices. Because the (1) physician offices are currently using Epic Corporation’s back office billing system with an outstanding record of accurate coding and short “days in Accounts Receivable” and (2) Epic’s EMR has a high ranking in industry HIT assessments, the executive team is proposing the purchase of Epic’s clinical EMR (documentation, ancillaries, orders, and patient portal).
The CFO is supportive but skeptical, as the Epic bid is approximately $1.5 M to implement the clinical software with a continued $300K per year in software maintenance and support. Current clinical technologies information systems are fra ...
A deep appreciation for ergonomics is at the core of Humanscale. Ergonomics is the study of how to improve efficiency and comfort in a work place. Correct ergonomic design helps to reduce discomfort at work, which increases job satisfaction, productivity and well-being – and reduces costs to the organization in the long run. All of Humanscale’s work tools were created to be intuitive and adjust effortlessly to the user. We consult with our team of in-house ergonomists on every project to ensure our products are the most comfortable available. Please use the links below to find out more about our Humanscale Consulting Services and read some advice from our experts on how to use ergonomics to create a more comfortable place to work:
Learn how to identify and track indicators of your company's financial health. Dave Justus, Kareo's Chief Financial Officer, and Ted Stack, founder of Falcon Capital Partners, will discuss the key performance benchmarks and insights you should pay attention to when working to optimize your billing company business.
The document contains three summaries:
1) The first summary discusses the importance of transparency in medical bill review programs. It notes that net savings, not ROI or other metrics, best indicates program performance. Without transparency into clear data and overall results, bill review programs cannot be optimally effective.
2) The second summary provides information on heat-related illnesses for workers and others. It identifies heat cramps, heat exhaustion, and heat stroke as the main forms of heat illness, with heat stroke being life-threatening. Risk factors include heavy work, protective clothing, poor physical fitness, and certain medical conditions.
3) The third summary announces a free webinar series from the Certification Institute on
› Benefits associated with Epicor ERP — $3,826,700. The Organization experienced productivity improvements and cost avoidance over five years through Epicor's various suites, including: financial management ($602,500), supply chain ($861,900), production management ($374,300), planning and scheduling ($185,300), sales management ($775,000), governance ($567,200), and business architecture ($460,600).
› Costs associated with Epicor ERP — $1,884,500. The Organization incurred costs over five years for implementation ($350,000), hardware ($100,000), Epicor software/services ($373,100), and ongoing management ($1,061,400
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMRs have failed. Providers must use certified EMR applications or face penalties. Funding sources for implementation include federal loans and grants, with $19.5 billion earmarked in stimulus funds starting in 2011. Long term benefits include improved quality, safety, efficiency and access to patient health data.
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMR implementations have failed. It also outlines funding sources like federal loans and grants, and long term benefits like reduced errors and improved care coordination. Certification requirements and panels to ensure EMRs meet standards are also discussed.
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMR implementations have failed. It also outlines funding sources like federal loans and grants, and long term benefits like reduced errors and improved care coordination. Certification requirements and panels to develop standards are discussed to ensure EMRs meet federal meaningful use criteria.
The document discusses key considerations for healthcare providers implementing electronic medical records (EMRs) in preparation for federal mandates going into effect in 2014. It notes that EMR implementation can be expensive but more affordable through software-as-a-service agreements. It also outlines various funding sources including federal loans and grants as well as expected long-term benefits like reduced errors and improved care coordination. Vendors' software must meet certification requirements to qualify for federal incentive payments.
This document discusses the importance of senior finance professionals understanding enterprise resource planning (ERP) systems and their financial implications. It covers:
1. ERP systems are typically a company's largest IT investment but their business and financial impacts are often misunderstood.
2. It is important for CFOs and finance teams to understand ERPs because they can help with financial planning, control, and as system users.
3. The lifecycle of an ERP includes evaluation, implementation, upgrades, and ongoing maintenance which impact costs and benefits over 10-15 years.
1Within the EHR[footnoteRef1] [1 ] [Student Name Removed.docxvickeryr87
1
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Abstract— This research paper was conducted to demonstrate the usefulness, positives, negatives and challenges associated with implementing the Electronic Health Record in a small private family practice group. Further use of research in this paper includes pieces on project implementation, government security accordance and system recommendations.
INTRODUCTION
Health information technology (HIT) has been revolutionized by the development of the electronic health record (EHR) and its expansion. The generalization of its use includes the transformation of paper patient charts and protected health information (PHI) into electronic forms and from there the options to revolutionize HIT began. The development of the EHR has brought a multitude of advantages and challenges with its implementation in the HIT world. Although the functions of EHR have allowed for both public and private sectors to utilize its possibilities, the private sector will be focused on in this situation. The ability for an electronic system to safely document, record, save, integrate and share with other instantly has allowed HIT to expand rapidly to all corners of the world.
EHR functionalities
In health information technologies, electronic health records have been identified by the Institute of Medicine as having eight core components which include the following [1]: recording patient health information and data, result management, physician order management, decision support, electronic communication and connectivity, patient support, administrative process and reporting, reporting requirements, and population health. Table 1 allows a visual representation of the core components along with other variable options available through the EHR [2]:
As seen, the electronic health record is much more than digitized patient records. As the EHR has the ability to provide functions ranging from patient care through supportive administration functions and even the function of informational infrastructure guidance in order to better aid the staff of the practice in clinical and clerical office services.
Integration of Practice Management System
Practice management systems (PMS) have multiple levels of integration with electronic health record systems yet there are difficulties at each level. Levels of integration can range from full system communication sharing all data entered in to each system or select data pending on the organizations need for level of integration from one system to another [3]. To distinguish the two systems, practice management systems provide more clerical functions of a physician’s office such as patient billing profiles, insurance verification, appointment scheduling and sending appointment reminders [3]. Co-coordination between the two systems have become increasingly more difficult due to the evolution and development of multiple EHR products. As organizations develop new electronic h.
The document discusses benchmarking in facilities management. It provides an overview of benchmarking programs and metrics used for comparison. Key metrics discussed include operating margin, expense per adjusted patient day, revenue per FTE, occupancy rate, and length of stay. The document also discusses challenges in facilities management benchmarking and comparing across organizations with different structures, operations, and infrastructure.
ISM ppt unit 2 sem5 bba gibs mr jasjeet singhhardikdogra3
This document discusses cost benefit analysis (CBA). It defines CBA as a process that analyzes systems or projects to maximize benefits. A CBA estimates all costs and potential profits of a business decision. It identifies tangible and intangible costs, as well as fixed, variable, direct and indirect costs. It also identifies monetary and nonmonetary benefits. The document provides an example CBA of a hospital expanding operations. It calculates costs and benefits to determine if the decision's benefits outweigh its costs. Finally, it discusses considering both quantitative and qualitative factors in a CBA.
Tom LeClair's B.R.A.I.N. ~ T.R.U.S.T. consulting descriptionTom LeClair
The document outlines services to help organizations manage healthcare costs including: conducting claims data analysis to identify high-cost benefits and users; developing strategies to forecast return on investment of disease prevention and management programs; and designing wellness programs that financially incentivize employees to improve health. The services also aim to demonstrate to management how embracing wellness increases productivity and profits through investing in recruiting, training, and retaining quality employees.
eCompliance, Chris Ferguson_The Business Value of Safety (ROI)eCompliance
As safety professionals, we can often do a better job of
communicating the business value of safety and viewing
safety as an integrated part of business strategy and
daily operations. More often than not, we disregard the
connection and incorrectly evaluate the ROI of safety.
Join Chris Ferguson and Adrian Bartha as they address
the key areas your business should focus on when
evaluating the value of safety.
Health risks @ Electro Magnetic Radiation white paper & solution documentBrightsandz Technologies
You may address it as ElectroMagnetic Radiation or Microwave Radiation or ElectroSmog. One way or the other, man made sources of radiation may the most significant pollution that human activity has produced in this century. All the more because it is intangible, invisible and insensible.
This paper addresses the issue of electromagnetic radiation (EMR), while seeking to separate the fact and the myth about EMR.
It connects through a variety of relevant topics such as source of EMR and the effect of EMR on birds, animals, bats, bees; to the microwaving effect on human tissue and the key risks associated.We have covered the inadequate standards and the legislation and relevant case studies.
paper_Measuring the Efficiency and Productivity Change of APEC Mobile Telecom...Nicky Chao
The document analyzes the efficiency and productivity change of 28 mobile telecommunications operators in APEC countries from 2003 to 2008. It finds that productivity increased by 5.5% over this period, primarily due to improvements in technical efficiency rather than innovation. Specifically, it used data envelopment analysis and Malmquist index approaches to measure efficiency based on operating revenue, subscribers, employees, assets, and capital expenditures. The most efficient operators were KDDI, Telkomsel, and Smart Communication, while others like Verizon Wireless and AT&T had technical efficiency below 0.6 on average.
The document discusses methods for measuring performance and clinical outcomes in healthcare. It describes the major domains of patient safety measurement as harm, mortality, infections, readmissions, patient satisfaction, and safety culture. It then focuses on defining medical errors and adverse events, and explaining why measurement is important for evaluating current systems and improving outcomes. Different methods of data collection are outlined, including direct observation, cohort studies, record review, and incident reporting systems. The Global Trigger Tool for assessing harm using chart review is also summarized.
Supply Chain Metrics That Matter: A Focus on Hospitals - 6 JAN 2013Lora Cecere
Executive Overview
Growth is slowing. Profitability is tougher. Compliance mandates are growing. How do companies balance the goals for value-based outcomes for health and wellness with costs? In this environment, supply chain matters more than ever.
In this report, we share insights on healthcare supply chains. Grown out of the offices of procurement, the supply chain function of the hospital is still in its infancy; but based on increasing business requirements and complexity, it is only beginning to show its true potential.
Growth: Futures are Uncertain.
The hospital administrator is facing many challenges. Growth is slowing and pressures are growing. The question is how to balance patient outcomes with better cost management. How does a hospital move forward with an uncertain future? And, what will be the impact of healthcare reform?
In table 1, we list top line growth over the past decade for four companies operating within the hospital industry. While there are ups and downs, the general trend is downward.
Healthcare Service delivery efficiency; performance of gauteng hospitalsOliver Nwauka
There is a general perception that public healthcare service delivery is deteriorating severely, despite government commitments to change this. This dysfunction stems from the cumulative impact of burden of diseases, economic pressures, population surge, policy and strategy incoherence and managerial incompetence. The core objective of this qualitative research study therefore, is to gain insight into the cause-effects of this sub-minimal performance, patients’ dissatisfaction and the waste of resources in Gauteng’s public healthcare sectors, with an intention to provide recommendations in resolving this crisis and to further this research.
This research made use of Performance Assessment Tools for quality improvement in Hospitals (PATH) framework and Data Envelopment Analysis (DEA) to evaluate the satisfaction levels, performance and technical efficiencies of public hospitals, which were compared to the private sector.
The findings agree that the satisfaction of patients is poor, performance sub-minimal and technically inefficient and health outcomes unsatisfactory relative to private hospitals. Patients’ dissatisfaction level was 76%. The efficiency constant returns to scale (CRS) were (40%), (63%) and (100%) respectively for district, regional and private hospitals while their variable returns to scale (VRS) were 60%, 37% and 100% with scale efficiency score of 92%, 52% and 100 % in that order. Health outcomes such as patients re-admission within a 28-day period recorded 20%, 21%, <5% for the district, regional and private hospitals respectively, and PHC health outcome (25%).
The lack of patient satisfaction, performance slack and inefficiency resulted partly from overall poor decision-making abilities on the use and allocation of resources and the lack of integrated information systems in the facilities
This document discusses various topics related to health care management and patient satisfaction. It addresses how to delight patients, provide quality service, and handle complaints effectively. It emphasizes treating the patient as the most important person and focusing on their experience. Specific tips are provided for dealing with angry patients and common patient complaints. The importance of seeing things from the patient's perspective is highlighted. Overall, the document stresses prioritizing excellent patient care, communication and satisfaction.
The insights driving superior healthcare outcomes in Asia Pacific.
Asia-Pacific Insight Magazine brings together IMS Health experts from across the region, delivering fresh perspectives on how to navigate through the challenges and opportunities in Asia-Pacific pharmaceutical market.
This Discussion offers you the opportunity to apply return on in.docxgasciognecaren
This Discussion offers you the opportunity to apply return on investment (ROI) concepts in a real case scenario. As is often the case, technology offerings involve costs that must be justified by virtue of expense reductions for revenue increases in the organization. There are creative opportunities in the Discussion for leaders to facilitate the development of the revenues into the organization and operational changes that reduce expenses.
Scenario:
Dynamic Health System is a 3-hospital, 500-bed system in the Midwest United States. This system employs 100 physicians, both primary care and specialists, in 12 physician practices. Dynamic also runs a center of excellence in orthopedic care for the large geriatric population in the area, including an outpatient rehabilitation facility that is currently profitable. Dynamic offers a full spectrum of medical and surgical services to their population with an emphasis on programs of excellence in orthopedic surgery, diabetes, and women’s care.
Dynamic’s typical patient mix is over 45% Medicare with another 35% private pay patients covered by three large insurance companies. Their Medicaid population is approximately 12%, with the reminder of patients self-pay.
Due to market forces, the three private payers have begun to implement a program of bundled payments for their members in the following areas: hip replacements, knee replacements, and lower back surgeries. In these models, Dynamic hospitals and employed physicians will be paid a fixed amount for an entire episode of care from pre- surgery evaluation, through surgery and post-surgery, physical therapy, and rehabilitation. Medicare is likewise proposing a pilot study for a population of hip replacement beneficiaries to assess the outcomes of care as opposed to procedure costs as a result of Dynamic’s petition to receive increased payments for beneficiaries due to age demographics and for being the only orthopedic geriatric center in 200 miles.
As a result of these factors and the aging HIT infrastructure, the Chief Medical Officer (CMO), Chief Executive Officer (CEO), and Chief Information Officer (CIO) of Dynamic are proposing the purchase of a monolithic Electronic Health Record (EMR) solution that will provide complete online documentation, orders, pharmacy, labs, and patient portal for all hospitals and employed physician offices. Because the (1) physician offices are currently using Epic Corporation’s back office billing system with an outstanding record of accurate coding and short “days in Accounts Receivable” and (2) Epic’s EMR has a high ranking in industry HIT assessments, the executive team is proposing the purchase of Epic’s clinical EMR (documentation, ancillaries, orders, and patient portal).
The CFO is supportive but skeptical, as the Epic bid is approximately $1.5 M to implement the clinical software with a continued $300K per year in software maintenance and support. Current clinical technologies information systems are fra ...
A deep appreciation for ergonomics is at the core of Humanscale. Ergonomics is the study of how to improve efficiency and comfort in a work place. Correct ergonomic design helps to reduce discomfort at work, which increases job satisfaction, productivity and well-being – and reduces costs to the organization in the long run. All of Humanscale’s work tools were created to be intuitive and adjust effortlessly to the user. We consult with our team of in-house ergonomists on every project to ensure our products are the most comfortable available. Please use the links below to find out more about our Humanscale Consulting Services and read some advice from our experts on how to use ergonomics to create a more comfortable place to work:
Learn how to identify and track indicators of your company's financial health. Dave Justus, Kareo's Chief Financial Officer, and Ted Stack, founder of Falcon Capital Partners, will discuss the key performance benchmarks and insights you should pay attention to when working to optimize your billing company business.
The document contains three summaries:
1) The first summary discusses the importance of transparency in medical bill review programs. It notes that net savings, not ROI or other metrics, best indicates program performance. Without transparency into clear data and overall results, bill review programs cannot be optimally effective.
2) The second summary provides information on heat-related illnesses for workers and others. It identifies heat cramps, heat exhaustion, and heat stroke as the main forms of heat illness, with heat stroke being life-threatening. Risk factors include heavy work, protective clothing, poor physical fitness, and certain medical conditions.
3) The third summary announces a free webinar series from the Certification Institute on
› Benefits associated with Epicor ERP — $3,826,700. The Organization experienced productivity improvements and cost avoidance over five years through Epicor's various suites, including: financial management ($602,500), supply chain ($861,900), production management ($374,300), planning and scheduling ($185,300), sales management ($775,000), governance ($567,200), and business architecture ($460,600).
› Costs associated with Epicor ERP — $1,884,500. The Organization incurred costs over five years for implementation ($350,000), hardware ($100,000), Epicor software/services ($373,100), and ongoing management ($1,061,400
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMRs have failed. Providers must use certified EMR applications or face penalties. Funding sources for implementation include federal loans and grants, with $19.5 billion earmarked in stimulus funds starting in 2011. Long term benefits include improved quality, safety, efficiency and access to patient health data.
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMR implementations have failed. It also outlines funding sources like federal loans and grants, and long term benefits like reduced errors and improved care coordination. Certification requirements and panels to ensure EMRs meet standards are also discussed.
The document discusses the challenges and requirements around implementing electronic medical records (EMRs) based on federal mandates. It notes that EMR standards will not be available until 2010-2011, implementation costs are high, and about 1/3 of existing EMR implementations have failed. It also outlines funding sources like federal loans and grants, and long term benefits like reduced errors and improved care coordination. Certification requirements and panels to develop standards are discussed to ensure EMRs meet federal meaningful use criteria.
The document discusses key considerations for healthcare providers implementing electronic medical records (EMRs) in preparation for federal mandates going into effect in 2014. It notes that EMR implementation can be expensive but more affordable through software-as-a-service agreements. It also outlines various funding sources including federal loans and grants as well as expected long-term benefits like reduced errors and improved care coordination. Vendors' software must meet certification requirements to qualify for federal incentive payments.
This document discusses the importance of senior finance professionals understanding enterprise resource planning (ERP) systems and their financial implications. It covers:
1. ERP systems are typically a company's largest IT investment but their business and financial impacts are often misunderstood.
2. It is important for CFOs and finance teams to understand ERPs because they can help with financial planning, control, and as system users.
3. The lifecycle of an ERP includes evaluation, implementation, upgrades, and ongoing maintenance which impact costs and benefits over 10-15 years.
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Abstract— This research paper was conducted to demonstrate the usefulness, positives, negatives and challenges associated with implementing the Electronic Health Record in a small private family practice group. Further use of research in this paper includes pieces on project implementation, government security accordance and system recommendations.
INTRODUCTION
Health information technology (HIT) has been revolutionized by the development of the electronic health record (EHR) and its expansion. The generalization of its use includes the transformation of paper patient charts and protected health information (PHI) into electronic forms and from there the options to revolutionize HIT began. The development of the EHR has brought a multitude of advantages and challenges with its implementation in the HIT world. Although the functions of EHR have allowed for both public and private sectors to utilize its possibilities, the private sector will be focused on in this situation. The ability for an electronic system to safely document, record, save, integrate and share with other instantly has allowed HIT to expand rapidly to all corners of the world.
EHR functionalities
In health information technologies, electronic health records have been identified by the Institute of Medicine as having eight core components which include the following [1]: recording patient health information and data, result management, physician order management, decision support, electronic communication and connectivity, patient support, administrative process and reporting, reporting requirements, and population health. Table 1 allows a visual representation of the core components along with other variable options available through the EHR [2]:
As seen, the electronic health record is much more than digitized patient records. As the EHR has the ability to provide functions ranging from patient care through supportive administration functions and even the function of informational infrastructure guidance in order to better aid the staff of the practice in clinical and clerical office services.
Integration of Practice Management System
Practice management systems (PMS) have multiple levels of integration with electronic health record systems yet there are difficulties at each level. Levels of integration can range from full system communication sharing all data entered in to each system or select data pending on the organizations need for level of integration from one system to another [3]. To distinguish the two systems, practice management systems provide more clerical functions of a physician’s office such as patient billing profiles, insurance verification, appointment scheduling and sending appointment reminders [3]. Co-coordination between the two systems have become increasingly more difficult due to the evolution and development of multiple EHR products. As organizations develop new electronic h.
The document discusses benchmarking in facilities management. It provides an overview of benchmarking programs and metrics used for comparison. Key metrics discussed include operating margin, expense per adjusted patient day, revenue per FTE, occupancy rate, and length of stay. The document also discusses challenges in facilities management benchmarking and comparing across organizations with different structures, operations, and infrastructure.
ISM ppt unit 2 sem5 bba gibs mr jasjeet singhhardikdogra3
This document discusses cost benefit analysis (CBA). It defines CBA as a process that analyzes systems or projects to maximize benefits. A CBA estimates all costs and potential profits of a business decision. It identifies tangible and intangible costs, as well as fixed, variable, direct and indirect costs. It also identifies monetary and nonmonetary benefits. The document provides an example CBA of a hospital expanding operations. It calculates costs and benefits to determine if the decision's benefits outweigh its costs. Finally, it discusses considering both quantitative and qualitative factors in a CBA.
Tom LeClair's B.R.A.I.N. ~ T.R.U.S.T. consulting descriptionTom LeClair
The document outlines services to help organizations manage healthcare costs including: conducting claims data analysis to identify high-cost benefits and users; developing strategies to forecast return on investment of disease prevention and management programs; and designing wellness programs that financially incentivize employees to improve health. The services also aim to demonstrate to management how embracing wellness increases productivity and profits through investing in recruiting, training, and retaining quality employees.
eCompliance, Chris Ferguson_The Business Value of Safety (ROI)eCompliance
As safety professionals, we can often do a better job of
communicating the business value of safety and viewing
safety as an integrated part of business strategy and
daily operations. More often than not, we disregard the
connection and incorrectly evaluate the ROI of safety.
Join Chris Ferguson and Adrian Bartha as they address
the key areas your business should focus on when
evaluating the value of safety.
Chapter EighteenManagement Making It WorkChapter OutlineMan.docxchristinemaritza
Chapter Eighteen
Management: Making It Work
Chapter Outline
Managing Labor Costs and Revenues
Managing Labor Costs
Number of Employees (a.k.a.: Staffing Levels or Headcount)
Hours
Benefits
Average Cash Compensation (Fixed and Variable Components)
Budget Controls: Top Down
Budget Controls: Bottom Up
Embedded (Design) Controls
Managing Revenues
Using Compensation to Retain (and Recruit) Top Employees
Managing Pay to Support Strategy and Change
Communication: Managing the Message
Say What? (Or, What to Say?)
Opening the Books
Structuring the Compensation Function and Its Roles
Centralization–Decentralization (and/or Outsourcing)
Ethics: Managing or Manipulating?
Your Turn: Communication by Copier
Still Your Turn: Managing Compensation Costs, Headcount, and Participation/Communication Issues
This chapter is about making it work: ensuring that the right people get the right pay for achieving the right objectives in the right way. The greatest pay system design in the world is useless without competent management. So why bother with a formal system at all? If management is that important, why not simply let every manager pay whatever works best? Such total decentralization of decision making could create a chaotic array of rates. Managers could use pay to motivate behaviors that achieved their own immediate objectives, not necessarily those of the organization. Employees could be treated inconsistently and unfairly.
This was the situation in the United States in the early 1900s. The “contract system” made highly skilled workers managers as well as workers. The employer agreed to provide the “contractor” with floor space, light, power, and the necessary
666
raw or semifinished materials. The contractor hired and paid labor.1 Pay inconsistencies for the same work were common. Some contractors demanded kickbacks from employees’ paychecks; many hired their relatives and friends. Dissatisfaction and grievances were widespread, eventually resulting in legislation that outlawed the arrangement.
Corruption and financial malfeasance were also part of decentralized decision making in the early 1900s. Some see parallels today. To help avoid history repeating itself and to redeem HR (and compensation) vice presidents from the image of unindicted coconspirators, the compensation system should be managed to achieve the objectives in the pay model: efficiency, fairness, and compliance.
Any discussion of managing pay must again raise the basic questions: So what is the impact of the decision or technique? Does it help the organization achieve its objectives? How?
Although many pay management issues have been discussed throughout the book, a few remain to be called out explicitly. These include (1) managing labor costs, (2) managing revenues, (3) communication, and (4) designing the compensation department.
MANAGING LABOR COSTS AND REVENUES
Financial planning is integral to managing compensation. As we noted in Chapter 1, compensation decisions influence organizati ...
This document discusses the implementation of electronic medical records (EMRs) in healthcare as mandated by 2014. It notes that current EMR vendors do not meet federal requirements and standards are still being developed. The costs of implementation are high and there are barriers like funding, IT resources, and provider resistance. It provides answers to questions about costs, funding sources like grants and loans, and the long-term benefits of EMRs like reduced errors and improved care coordination.
The document discusses key points healthcare providers should know about implementing electronic medical records (EMRs) by the 2014 mandate. It notes that current EMR vendors do not fully meet federal requirements and standards are still being developed. EMRs will be very expensive to implement and maintain, though government loans and grants are available to help fund them. Proper implementation requires addressing barriers like costs, unclear returns on investment, training needs, and resistance to change. Non-adoption will result in lower Medicare reimbursements starting in 2015.
Analyzing Financial Projections as Part of the ESOP Fiduciary Process | Appra...Mercer Capital
In recent years there has been increasing concern among ESOP sponsors and professional advisors (trustees, TPAs, business appraisers, legal counsel) regarding the scrutiny of the DOL, the Employee Benefits Security Administration (“EBSA”), and the Internal Revenue Service (“IRS”). These entities (and agencies thereof) are tasked with ensuring that ESOPs comply with the Employee Retirement Income Security Act (“ERISA”) as well as with various provisions of the federal income tax code concerning qualified retirement plans (including ESOPs). Citing concerns for poor quality and inconsistency in business appraisals, the DOL has sought in recent years to expand the meaning of “fiduciary” under ERISA to include business appraisers. In the most recent forums of exchange and deriving from various court actions, there are numerous areas of concern that DOL/EBSA appear to have regarding ESOP valuations.
This paper focuses on the use of financial projections in ESOP valuations. The use (or misuse) of financial projections is often the most direct cause of over- or under-valuation in ESOPs.
New Ways To Manage Your Vet Practice With Financialsmjmcgaunn
This document provides an overview of new ways to manage a veterinary practice using financial metrics and key performance indicators. It discusses tools like income statements, dashboards, balanced scorecards, benchmarks and financial strength indexes that can help owners and managers track the financial health and performance of the practice over time. The document emphasizes using visual representations of key data to more easily identify trends, issues, and opportunities for improved decision making.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
1. Analysis Series 2008
Measuring the Financial Impact of
Electronic Medical Records
Vertex Healthcare Consulting’s Financial Impact Tool for EMR’s
2. Copyright 2008 Vertex Healthcare Consulting, LLC
All rights reserved. No part of this paper may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or by any information storage or
retrieval system without written permission from Vertex Healthcare Consulting, LLC.
For reprint requests, please contact:
Vertex Healthcare Consulting, LLC, 2825 E. Cottonwood Parkway, Suite 500, Salt Lake City, UT 84121
Telephone: 801.207.8220, E-Mail: info@vertexhealthcare.com, or visit our website at
www.vertexhealthcare.com
3. Analysis Series 2008
Measuring the Financial Impact of
Electronic Medical Records
Vertex Healthcare Consulting’s Financial Impact Tool for EMR’s
4.
5. 1 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
Executive Summary
Electronic Medical Record (EMR) systems are inevitable in the future of healthcare. Most healthcare
professionals acknowledge that EMRs will play a significant role long-term, but because these systems
are complex and capital intensive many managers and executives struggle to justify their
implementation.
From a clinical and operations perspective, many of the benefits of an EMR are extremely difficult to tie
directly to financial measurements. It is unreasonable to expect the approval of the capital budget
necessary to purchase an EMR on the assumption alone that some or all of these benefits may be
realized. The question still remains, “Do the benefits outweigh the costs of implementing and
maintaining an EMR system?”
Vertex Healthcare Consulting responded to the challenge of measuring the financial impact of an EMR.
We began with a review of relevant industry articles, studies, and financial models. We then combined
the results of our research with our experience and expertise to produce a Financial Impact Tool for
Electronic Medical Records (FIT for EMR). This tool calculates the “hard” benefits of an EMR; benefits
that can be financially measured, quantified, and defined.
The development of the FIT for EMR model was a four-step process. First, we defined relevant financial
terms. Second, we developed the line-item detail to reflect the implementation and management costs
of an EMR. Third, we developed the line-item detail for EMR benefits, backed by industry sources and
clinical data. Finally, we applied financial modeling adjustments to appropriately represent costs and
benefits over time.
The result of our efforts was the FIT for EMR model. This model is a dynamic, Excel-based tool that
calculates the financial impact of EMR system. An executive or manager can use it to demonstrate the
financial impact of an EMR on his or her organization. The model produces a comprehensive financial
impact summary report that includes four key financial metrics, a five-year financial pro forma and
supporting documentation.
Managers and executives in the healthcare community will always face the challenge of financially
justifying the use of an EMR to improve the delivery of care. The FIT for EMR model is a tool that offers
a solution that substantiates the benefits of an EMR through a process that is measurable, transparent,
and defensible. With this tool, executives can have a high level of confidence when calculating the
financials benefits of implementing an EMR.
Copyright 2008 Vertex Healthcare Consulting, LLC
6. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 2
The Challenge
For the manager or executive that is championing the adoption of an Electronic Medical Record (EMR),
the biggest obstacle that must be overcome is measuring the true financial impact of the EMR on the
organization. There is little argument that an EMR, properly implemented, provides numerous benefits;
including: improved patient safety, increased quality, patient and clinician satisfaction, costs savings,
and revenue increases. The question remains, “Do the benefits outweigh the costs of implementing and
maintaining the EMR system?”
From a clinical and operations perspective, the benefits that appear to be the most persuasive reasons
for adopting an EMR, quality, safety, and satisfaction, happen to be the benefits that are extremely
difficult to tie directly to financial measurements.
It is unreasonable to expect executives or boards to approve the capital budget necessary to purchase
an EMR on the assumption alone that these “soft” benefits may be realized. A “soft benefit” by
definition is difficult to measure in financial terms and is usually described as intangible or qualitative.
Meeting the challenge of measuring the financial impact of an EMR necessitates using only “hard
benefits”, in other words, benefits that can be quantified, defined, and associated with specific financial
measures. These “hard” benefits include: cost savings for supplies, staff, and services; as well as
revenue increases.
Throughout the healthcare industry there have been many attempts to define and set forth these
measurable financial benefits through cost studies, research, sampling, and industry statistics. As a
result, there are numerous models that attempt to measure the financial impact of an EMR, in terms of
returns, costs, benefits, and break-even. With all of the alternatives available, it is challenging for a
manager or executive to determine what should be used to evaluate the financial impact of an EMR on
his or her organization.
Our Approach
Vertex Healthcare Consulting has combined many industry resources with our experience to produce a
comprehensive “Financial Impact Tool for Electronic Medical Records” (FIT for EMR).
The development of the FIT for EMR model began with a review of relevant industry articles and
previous studies. Next, it included the evaluation of several existing ROI models. We compiled the
results of our research and testing and then augmented these with actual client data as well as clinical
observations and cost study outcomes. With this body of knowledge we then applied a four-step
methodology for the development of the FIT for EMR model.
Copyright 2008 Vertex Healthcare Consulting, LLC
7. 3 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
Our research included articles from the American Journal of Medicine, the Healthcare Financial
Management Association, the American College of Surgeons, and the American Academy of Family
Physicians; we also reviewed national publications from the American Medical Association, the
American College of Healthcare Executives, and HCPro, Inc. From these sources we compiled the
specific components of our model and evaluated the different methodologies of calculating financial
impact. Additionally, we tested and analyzed many “ROI” models available from EMR vendors, national
associations and consulting groups. We evaluated the look and feel of each model, outlined its
assumptions and calculations, and verified the data sources. The values from these models were also
used to calibrate and reconcile those gathered from our industry research and client observations.
There were several critical areas where specific costs and benefits were not sufficiently defined within
the publications researched. In these instances, we turned to our own internal resources consisting of:
actual client project results, compiled internal benchmarks, and the expertise of licensed clinical
professionals.
The four-step methodology for developing the FIT for EMR model began with a clear definition of
relevant financial terms. The second and third steps consisted of developing specific and measurable
details for both EMR “costs” and EMR “benefits”. Finally, financial modeling adjustments were applied
to appropriately represent the financial costs and benefits over time.
The result of our approach was the creation of a dynamic, Excel based, tool that calculates the financial
impact of an EMR system. The FIT for EMR model was designed for an executive or manager to use to
demonstrate the financial impact of an EMR on his or her organization. The following section describes
the FIT for EMR development process.
Developing the FIT for EMR Model
Step 1 - Definition of Financial Terms:
As a result of the research conducted, it became apparent that the term ROI, was used as a blanket term
to indicate financial impact and project costs when discussing EMR systems. ROI stands for “Return on
Investment”, and in strict financial terms means, a return on a past or current investment, or the
estimated return on a future investment. ROI is usually represented as a percent rather than decimal
value. However, the term “ROI” is often used in place of or synonymous with other financial metrics
such as: break-even, net present value, internal rate of return, profit & loss or cost and benefit
statements.
When considering an EMR system, each of these metrics provides a slightly different view of the
financial impact of the EMR on the healthcare organization. For this reason, the FIT for EMR model
produces more than just an ROI percentage. The model actually calculates the following four financial
metrics and produces a 5-year financial pro forma:
Copyright 2008 Vertex Healthcare Consulting, LLC
8. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 4
Project Break-Even: Economically speaking, the break-even point is the point at which
cumulative costs and benefits are equal. At this point the project has no net loss or gain, and is
stated as, break-even. Relative to an EMR implementation, the “break-even” occurs after the
system “Go-live” at the point when cumulative benefits equal all cumulative costs, including
initial capital (start-up costs) and incurred ongoing operating costs.
Project Net Present Value: NPV for a project is the present value of the project benefits minus
(-) the present value of the project investment. Present value is the value today of future costs
or benefits, discounted to reflect the time value of money. Present value calculations are widely
used in financial modeling to compare cash flows at different times on a meaningful like to like
basis.
Project 5-Year Return on Investment: ROI is the ratio of the benefit gained on a project relative
to the cost of the investment. ROI indicates cash flow from an investment over a specific period
of time, in this case 5 years. It measures investment profitability, not investment size. Return
on Investment is a percentage return based on capital invested. In general, the higher the
investment risk, the greater the potential investment return, and the greater the potential
investment loss.
Project Internal Rate of Return: The internal rate of return (IRR) is a capital budgeting metric
used to decide whether an investment should be made. It is an indicator of the efficiency of an
investment. The IRR is the annualized effective compounded return rate which can be earned
on the invested capital. A project is a good investment if its IRR is greater than the rate of return
that could be earned by alternate investments.
Project Pro Forma Financials: A pro forma document is provided in advance of an actual
project. This document serves as a model for the anticipated financial outcomes of the actual
project. The pro forma financials provide the basis from which the other financial metrics are
calculated, by projecting in detail the line item costs and benefits of the project over time.
Step 2 – Development of Cost Detail:
The development of the cost detail was the first of two foundational sections in the FIT for EMR model.
In simplest terms, the model measures the difference between EMR costs and EMR benefits. The model
is structured on detailed line items that represent comprehensive costs associated with purchasing,
implementing, and maintaining an EMR system.
The model utilizes annual organizational costs. Annual costs are used rather than per patient or per
provider calculations to ensure usability for a variety of organizations. Developing the cost detail
required categorizing costs, defining the “go-live” timeframe, identifying “other” cost factors, and
specifying all cost line items.
Copyright 2008 Vertex Healthcare Consulting, LLC
9. 5 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
Categorizing Costs: The FIT for EMR model assigns costs to two major groups. The first group is
“Capital Costs”. The model places all costs incurred by an organization associated with the
procurement and implementation of an EMR system into this category. Another way of
describing these costs would be to call them “Start-up Costs”. An organization may or may not
choose to treat all of these costs as “capital”; however, for the purpose of the model they are
identified as such.
The second group is “Ongoing Operating Costs”. These costs consist of all items and services
required to operate and maintain an EMR on an ongoing basis. The model only includes costs in
this category that occur after the “Go-live” of the EMR system.
Project “Go-live”: The term “Go-live” is almost exclusively associated with a software
implementation. Simply put, it is the day on which the system is put into productive use. The
“Go-live” date in the FIT for EMR model is used to clearly define the difference between Capital
and Ongoing Costs.
The “Go-live” date is also used as the starting point for the break-even calculation. The “Pre Go-
live” periods for organizations can be substantially different. Some EMR systems may be
implemented in as little as 90 days, while others may require several years. For this reason, the
FIT for EMR model calculates break-even from the “Go-live” date forward.
“Other” Cost factors: There are miscellaneous costs associated with an EMR. The FIT for EMR
model includes an estimate for hardware replacement costs and accommodates other
miscellaneous costs by providing the user with an “other” category for additional, organization
specific, Capital and Ongoing Costs.
To reflect the economic realities that organizations face, the model allows for annual cost
adjustments for contracted software maintenance and support. Additionally, annual
adjustments for staffing and other operating cost increases can be included to account for
inflation.
Cost Line Item Detail: As described above, the line item costs are grouped into two categories,
Capital and Ongoing Operating Costs. The FIT for EMR model intends that the line item costs
included must be directly attributed to the purchase, implementation, and management of the
EMR system. These costs will generally be found in the Vendor Bid/Estimate or the EMR System
Contract documents. Some of these costs will need to be estimates for use of internal resources
and for other acquired professional or consulting services.
Copyright 2008 Vertex Healthcare Consulting, LLC
10. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 6
Capital (Initial) Costs
• Software Licenses: This includes initial licensing fees for the EMR system as well as any
additional 3rd Party software (such as servers, scanning, security, fax & e-mail) required to
support the installation.
• Hardware & IT Installation: This line item consists of all equipment required for the EMR. It will
include PC’s, laptops, scanners, printers, back-up storage, networking devices, etc. Also, this cost
item includes all labor and support services required for configuring and installing the necessary
hardware and software.
• Hardware Replacement Cycle: Within the model, the user can specify the number of years
before replacement is necessary and the estimated percentage of the replacement cost.
Generally, a replacement cycle of 3 years and 50% cost of the original installation are used.
• Training & Travel Related Expenses: These costs are usually stipulated in the EMR Vendor
contract and will include training time as well as travel expenses associated with trainers coming
on-site. This is one area where costs included in Capital may actually occur after “Go-live”,
should the contract include hours for post “Go-live” support during the first several weeks of
operation.
• Project Management & Onsite Support: An effective EMR implementation almost always
requires dedicated project management resources. This line item should include costs associated
with project management whether contracted to an outside firm or provided by in-house
resources. Also, this item should include other onsite support services, not included in the
training item above.
• Data Migration: If moving from a paper-based medical record to and EMR, this cost item will
include scanning and data entry costs for historical records being loaded into the new system. If
an organization is moving from one computer-based system to another, customize “migration”
programming is almost always required. All costs for the migration process should be included in
this line item.
• Additional Customized Programming: If an organization is simply installing the EMR System “off
the shelf”, then no customized programming costs should be included. However, more often
than not, some customization will be required. If the Vendor contract specifies the costs for
these services separately, they will be included in this cost line item.
• Other Capital Costs: Item is for miscellaneous, organization-specific capital costs.
Ongoing Operating Costs (Annual)
• Software Maintenance & Support: Costs making up this line item include annual software
maintenance and support fees incurred post “Go-live”. These costs may be stipulated in the EMR
Contract with an annual percentage increase. The model allows for the inclusion of this annual
adjustment.
• EMR Support Staff (Salary & Benefits): An EMR system requires ongoing management and
database administration services. These are usually provided by in-house personnel. This line
item accounts for their salary and benefits as a component cost of maintaining the EMR.
• Other Operating Costs: Item is for miscellaneous, organization-specific ongoing operating costs.
Copyright 2008 Vertex Healthcare Consulting, LLC
11. 7 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
Step 3 – Development of Benefit Detail:
The development of the benefit detail was the most involved of the two foundational sections in the FIT
for EMR model. The challenge of measuring the financial impact of an EMR necessitates using only
“hard benefits”, in other words, benefits that can be quantified, defined, and associated with specific
financial measures.
In order to identify these “hard” benefits we combined our research, client data, clinical observations,
and cost studies to create a defensible list of measurable financial EMR benefits. These benefits include:
cost savings for supplies, staff, and services; as well as revenue increases associated with the proper
implementation and utilization of an EMR.
Categorizing Benefits: The FIT for EMR model assigns benefits to two major groups. The first
group is “Cost Savings”. The model places all benefits associated with the EMR system that
result in reduced costs to the organization in this category.
The second benefits group is “Revenue Increases”. In a clinical setting, it is proven that an EMR
improves both charge capture and coding accuracy. Each of these generates additional
revenues for the organization. In a correctional setting, an EMR provides a means for tracking
inmate utilization of healthcare services in a more timely and accurate manner. In institutions
where inmate co-pays are charged, an EMR greatly increases the likelihood of collecting these
payments.
Benefits Line Item Detail: As described above, the line item benefits are grouped into two
categories Cost Savings and Revenue Increases. Line items described below will include the
following: a narrative description; a Value Range that provides conservative, moderate and
aggressive values; an explanation of calculation used to determine benefit amount; and a reference
for the source of the benefit data.
Cost Saving: Benefits include supply, staff, and services savings.
• New Chart Supplies: Includes medical record folder, dividers, labels, forms and supply shelving.
Value Range: $2.00, $3.00, $4.41 per New Patient Encounter.
Original cost of $3.00 in 1997 adjusted annually for medical inflation
through 2007 at an average rate of 3.95% per year.
Calculation: Value x New Patient Encounters = Chart Supply Savings
Data Source: Healthcare Financial Management, Sept. 1997, “Computerized Patient
Records Benefit Physician Offices” by A. Bingham.
Copyright 2008 Vertex Healthcare Consulting, LLC
12. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 8
• New Chart Build: Staff minutes required to gather patient data and assemble new patient chart.
Value Range: 3 minutes, 5 minutes, 7 minutes per New Patient Encounter
Calculation: Value x New Encounters x Staff Cost per minute = Staff Savings
Data Source: Vertex Healthcare Consulting 2005-2007 client data gathered from
clinical workload staffing studies.
• Existing Chart Management: Minutes required by medical records staff to manage existing
patient records, excluding initial chart pull and re-filing. This line item accounts for loose paper
filing and general record storage management activities.
Value Range: 1 minutes, 2 minutes, 3 minutes per Existing Patient Encounter
Calculation: Value x Existing Encounters x Staff Cost per minute = Staff Savings
Data Source: Vertex Healthcare Consulting 2005-2007 client data gathered from
clinical workload staffing studies.
• Chart Pulls: Average cost for medical records staff to retrieve and re-file a paper chart.
Value Range: 50%, 75%, 100% of $5.88 per Clinical Encounter
Original cost of $5.00 in 2003 adjusted annually for medical inflation
through 2007 at an average rate of 3.91% per year.
Calculation: Percent Value x $5.88 x Total Clinical Encounters = Staff Savings
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
• Medical Records Requests: Includes all time and material costs associated with the creation of a
duplicate chart in response to a medical records request from an outside party (e.g. patient,
other provider, attorney, etc.).
Value Range: 7 minutes, 12 minutes, 17 minutes per Medical Record Request
Includes Medical Records Request Minutes + New Chart Build Minutes + Existing
Chart Management Minutes
Calculation: Value x Total Record Requests x Staff Cost per minute = Staff Savings
Data Source: Vertex Healthcare Consulting 2005-2007 client data gathered from
clinical workload staffing studies.
• Transcription: Estimated percentage savings of annual transcription costs based on
organization’s process and utilization of medical transcription.
Value Range: 50%, 75%, 100% reduction of annual transcription cost
Calculation: Percent Value x Annual Transcription Cost = Transcription Savings
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
Copyright 2008 Vertex Healthcare Consulting, LLC
13. 9 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
• Reusable Records Space: Cost per square foot of records storage space reclaimed for other
clinical or administrative uses.
Value Range: $1.25, $2.10, $3.00 per square foot per month.
Calculation: Value x Sq. Ft. of Reclaimed Space x 12 months = Annual Savings
Data Source: Estimated from national leasing data, will vary by geographic location.
• Prevention of Adverse Drug Events: Estimated percentage savings due to the reduction in
adverse drug events.
Value Range: 10%, 40%, 70% of $2.94 per Provider-Only Encounter.
Annual savings of $6,500 per provider divided by 2,500 provider-only
encounters = $2.60 savings per encounter. Original savings of $2.60 in 2003
adjusted annually for medical inflation through 2007 at an average rate of
3.91% per year.
Calculation: Percent Value x $2.94 x Provider-Only Encounters = Prevention Savings
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
• Medication Utilization & Compliance: Estimated percentage savings of annual medication costs
due to alternative drug suggestion reminders and improved formulary compliance.
Value Range: 5%, 15%, 25% of Annual Medication Costs.
Calculation: Percent Value x Annual Medication Costs = Medication Savings
Data Source: Healthcare Financial Management, Jan. 2002, “Financial Analysis
Projects Clear Returns from EMR”, Schmitt and Wofford.
The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
• Laboratory Order Entry Savings: Estimated percentage reduction of annual laboratory costs due
to improved decision support processes.
Value Range: 0%, 6.5%, 13% of Annual Laboratory Costs.
Calculation: Percent Value x Annual Laboratory Costs = Laboratory Savings
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
• Radiology Order Entry Savings: Estimated percentage reduction of annual radiology costs due to
improved decision support processes.
Value Range: 5%, 12%, 20% of Annual Radiology Costs.
Calculation: Percent Value x Annual Radiology Costs = Radiology Savings
Copyright 2008 Vertex Healthcare Consulting, LLC
14. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 10
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
• Outside Services Savings: Estimated percentage reduction of annual outside services costs due
to decreased utilization of emergency services; consistent scheduling of chronic care visits, and
leveraging of telemedicine services.
Value Range: 0%, 5%, 10% of Outside Services Costs.
Calculation: Percent Value x Annual Outside Service Costs = Annual Savings
Data Source: Vertex Healthcare Consulting 2005-2007 client data gathered from
correctional healthcare services assessments and financial turnaround
engagements.
Revenue Increases:
• Charge Capture Improvements: Estimated percentage of increased collections due to
computerizing the encounter form process, capturing procedures performed not previously
documented, and improving billing capture.
Value Range: 1.5%, 3.3%, 5.0% of Annual Collections.
Calculation: Percent Value x Annual Collections = Increased Collections Revenue
Data Source: The American Journal of Medicine, April 1, 2003 A Cost-Benefit
Analysis of Electronic Medical Records in Primary Care, Wang, A.,
Middleton, B., et al.
Healthcare Financial Management, Jan. 2002, “Financial Analysis Projects Clear
Returns from EMR”, Schmitt and Wofford.
The American College of Surgeons, Jul. 2007, “A Pilot Study to Document the
Return on Investment for Implementing an Ambulatory Electronic Health
Record at an Academic Medical Center”, Grieger, Cohen, and Krusch.
Family Practice Management, Nov. 2004, “Why It’s Time to Purchase an
Electronic Health Record System”, Adler.
• Coding Improvements: Estimated percentage of increased collections from better coding
accuracy due to automated prompts and required data fields; as well as improved administrative
and workflow functions.
Value Range: 3%, 9%, 15% of Annual Collections.
Calculation: Percent Value x Annual Collections = Increased Collections Revenue
Data Source: The Journal of Healthcare Information Management. Vol 17 No. 4 Fall
2003, “Analyzing Computer Based Patient Records: A Review of
Literature”, Erstad.
Copyright 2008 Vertex Healthcare Consulting, LLC
15. 11 FIT for EMR: A Model for Measuring the Financial Impact of an EMR
• Increased Inmate Co-pays: Estimated percentage increase in annual revenues from inmate co-
pay collections. In many correctional environments, institutional guidelines allow for the
collection of co-pays for inmate requested healthcare and prescriptions. An EMR facilitates
collection of these fees by automatically tracking utilization of services by type and request.
Value Range: 0%, 25%, 50% of $5.00 per Provider-Only Encounter.
Survey of correctional institutions inmate co-pays ranged from $2.00 to
$10.00 per encounter.
Calculation: Percent Value x $5.00 x Provider-Only Encounters = Increased Revenue
Data Source: Oklahoma Dept of Corrections Executive Budget 2004
Salt Lake County Jail Regulators Handbook Sept. 2003
Milwaukee Journal Sentinal June 6, 2004, Prisoners Health Costs Rise
500%, Marley
Step 4 – Financial Modeling Adjustments:
The final step in the FIT for EMR model development process was to establish an appropriate
financial modeling framework. The intent of the model is to forecast EMR performance with its
associated costs and benefits. Financial adjustments were applied to accurately represent cost
and benefit estimates over time and to reflect the cost of capital in today’s dollars.
Annual adjustments were applied to EMR “costs” to reflect the anticipated impact of inflation.
These adjustments were applied to Ongoing Operating Costs. The model allows the user to
input up to three different adjustment values to account for contracted rate increases, medical
inflation costs, and other annual adjustments.
To maintain consistency throughout the model, an annual adjustment is also applied to all EMR
“benefits”. The model allows the user to input a single benefit adjustment that is applied to all
benefit line items over a 5-year period. This benefit adjustment should mirror the adjustments
applied to costs; however the user can modify these adjustments to suit their specific
circumstances.
The final adjustment in the model is the application of a discount rate. The discount rate is the
rate used to discount future cash flows to their present values. The discount rate generally
equates to the organization’s cost of capital (cost of borrowing money).
The FIT for EMR model applies a discount rate to both the EMR costs and benefits in order to
calculate their Present Values. The default discount rate in the model is 7.5%; however, this
should be adjusted by the user to reflect their organization’s cost of capital.
Copyright 2008 Vertex Healthcare Consulting, LLC
16. FIT for EMR: A Model for Measuring the Financial Impact of an EMR 12
The Solution
The FIT for EMR Model:
Vertex Healthcare Consulting combined many industry resources with our own client experience, actual
clinical studies, and EMR implementation expertise to produce the FIT for EMR model. This model is a
dynamic, Excel-based tool that calculates the financial impact of EMR system. The FIT for EMR model
was designed for an executive or manager to use to demonstrate the financial impact of an EMR on his
or her organization. The tool allows the user to input cost and benefit values specific to their
organization and EMR system. It then produces a comprehensive financial impact summary report that
includes four key financial metrics, a five-year financial pro forma and supporting documentation for
sources and calculations.
Managers and executives in the healthcare community will always face the challenge of financially
justifying the use of technology to improve the delivery of care. The FIT for EMR model is a tool that
offers a solution that substantiates the benefits of technology through a process that is measurable,
transparent, and defensible.
Copyright 2008 Vertex Healthcare Consulting, LLC