Return on investment analysis for a computer-based patient record in the outpatient clinic setting.

While the computer-based patient record (CPR) is considered essential technology for improving efficiency and quality of health care, the high cost of CPR implementation has been a major barrier to widespread acceptance of these systems. This paper describes a framework to evaluate the costs and benefits of implementing CPR systems in outpatient clinical settings. Return on investment (ROI), a measurement of the difference between the costs of and benefits from an investment, is one method to evaluate the economic implications of CPR. The major costs in acquiring a CPR system include the costs of hardware, software, networking, ongoing maintenance, installation and training, and opportunity costs. Benefits of CPR systems include improved productivity by reducing resource utilization or improving revenues; improved quality by providing convenient access to information at the point of care, computerized physician-order entry and decision support systems; and intangible benefits that can not be simply quantified in monetary terms, such as enhanced data capture and access, enhanced business management and improved legal and regulatory compliance. We believe that understanding the ROI framework will enable physicians to make informed strategic decisions regarding purchase and implementation of CPR systems in their practices.