Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study
Authors
Subramanian, SujhaHoover, Sonja
Wagner, Joann L.
Donovan, Jennifer L.
Kanaan, Abir O.
Rochon, Paula A.
Gurwitz, Jerry H.
Field, Terry S.
UMass Chan Affiliations
Department of Medicine, Division of Geriatric MedicineMeyers Primary Care Institute
Document Type
Journal ArticlePublication Date
2012-05-01Keywords
Decision Support Systems, ClinicalHealth and Medical Administration
Health Services Research
Primary Care
Metadata
Show full item recordAbstract
In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.Source
J Am Med Inform Assoc. 2012 May-Jun;19(3):439-42. Epub 2011 Nov 18. doi:10.1136/amiajnl-2011-000179
DOI
10.1136/amiajnl-2011-000179Permanent Link to this Item
http://hdl.handle.net/20.500.14038/37111PubMed ID
22101906Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1136/amiajnl-2011-000179