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Submitted on September 26, 2005
Accepted on February 1, 2006
Affiliation of the authors: 1 Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Public Health, Weill Medical College of Cornell University, Ithaca, NY; 2 Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Health Policy and Management, Harvard School of Public Health, Boston, MA; 3 Eastern Research Groupo, Inc., Lexington, MA; 4 Information Systems, Partners Healthcare System, Boston, MA; 5 Department of Medicine, Columbia University Medical Center, New York, NY; 6 Brigham and Women's Hospital and Harvard Medical School, Boston, MA; 7 Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Information Systems, Partners Healthcare System, Boston, MA; 8 Department of Public Health, Weill Medical College of Cornell University, Ithaca, NY
* To whom correspondence should be addressed.
Objective Although computerized physician order entry (CPOE) may decrease errors and improve quality, hospital adoption has been slow. The high costs and limited data on financial benefits of CPOE systems are a major barrier to adoption. We assessed the costs and financial benefits of the CPOE system at Brigham and Women's Hospital over ten years.
Design Cost and benefit estimates of a hospital CPOE system at Brigham and Women's Hospital is a 720 adult bed, tertiary care, academic hospital in Boston.
Measurements Institutional experts provided data about the costs of the CPOE system. Benefits were determined from published studies of the BWH CPOE system, interviews with hospital experts and relevant internal documents. Net overall savings to the institution as well as operating budget savings were determined. All data are present value figures represented in 2002 dollars.
Results Between 1993 and 2002, the BWH spent $11.8 million to develop, implement, and operate CPOE. Over ten years, the system saved BWH $28.5 million for cumulative net savings of $16.7 million and net operating budget savings of $9.5 million given the institutional 80% prospective reimbursement rate. The CPOE system elements that resulted in the greatest cumulative savings were renal dosing guidance, nursing time utilization, specific drug guidance and adverse drug event prevention.
Discussion The CPOE system at BWH has resulted in substantial savings, including operating budget savings, to the institution over ten years.
Conclusion Other hospitals may be able to save money and improve patient safety by investing in CPOE systems.
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