Hospitals Face Hidden “Paperwork Overhaul” Costs With EMR Install

If you’re an IT exec, you know things projects rarely cost what you expected them to, and often take longer than  you’d hoped.  Healthcare being the tricky beast that it is, meanwhile, the problem is particularly acute.

Nowhere is that principle better illustrated than by the many “gotcha” costs that pop up when a hospital budgets for an EMR. Not only do many EMRs behave in unpredictable ways, they also have unexpected impacts on your hospital’s workflow and administrative policies.

I particularly like the way blogger R. Dirk Stanley explained the problem in a recent article. As he notes, technical problems may be the least of your worries. Hospitals often face unexpected administrative costs that vendors, let us say, don’t exactly play up in their sales pitch.

Stanley, CMIO of Northampton, MA-based Cooley Dickinson Hospital, describes a scenario in which a hospital picks a vendor to install and set up its EMR and train its staff for a total cost of $10 million.

So far so good? At first, perhaps. But then, the hospital’s IT leadership realizes that it faces some huge hidden costs, notably a “paperwork overhaul” that could include updates to order sets as well as clinical documentation, policies and protocols.

As he notes, paper versions of these four tools may contain overlapping information — something staffers can generally work through — but within an EMR that simply can’t happen, he notes. “You’ll be forced to divide your patient care instructions into one of these four buckets…and this can be expensive,” he writes.

After all, he says, changing these documents is no light matter. You’ll need clinicians to participate in committees which will make and approve changes to these critical tools.  Getting the information entered and checked within the system requires more time and expense. Then, what do you do if the vendor updates the system and you’re forced to reorganize again?  Spend more on updates, of course.

Stanley doesn’t cite a cost-overrun estimate, but my guess is we’re not talking about pocket change. Worse, if your tools update moves slowly, it could lead to delays in workflow reorganization, a costly (and scary) prospect on its own.

Seems to me that this problem isn’t getting enough attention in hospital IT circles. What do you think?

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.