Pediatric Informatics: Computer Applications in Child Health (Health ...

224 M.M. Simonian
16.3.1.4 Providing Decision Support
Clinical decision support (CDS) tools, covered in greater detail elsewhere in the
book (Chapters 10, 12, and 13) can provide clinicians with access to information
(through online libraries), they can guide entry and choices (through template
forms and clinical practice guidelines) for diagnosis and therapy, they can provide
knowledge-based prompts (via alerts and reminders) and they can help clinicians
understand practice. 9
16.3.1.5 Reusing Practice Data
Most EHR systems allow filtering of data elements that can be configured by
providers or practice managers. In addition to required reports, ad hoc queries
may be generated to help identify patterns according to patient demographics,
diagnosis (ICD) or therapy (CPT) codes. More complex queries can be used for
quality improvement, practice planning, continuous professional development 10
and research.
16.3.2 Costs
The most critical issue and the principal barrier to small practice adoption of EHRs
are the costs of a system. These costs include:
Base costs of hardware, software, and training
Costs to customize products
Costs to interface/integrate systems
Upgrade costs
16.3.2.1 Base Costs of Hardware, Software and Training
An example of cost ranges per provider of an EHR system is in Table 16.1.
Table 16.1 Cost range per provider of an electronic health record system 15
Base Range
System costs
Software (annual license) $1,600 $800–3,200
Implementation $3,400
Support and maintenance $1,500 $750–3,000
Hardware (three computers and network) $6,600 $3,300–9,000
Induced costs
Temporary productivity loss $11,200 $5,500–16,500