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Estimating the United States’ Cost of Healthcare Information Technology

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Healthcare Information Management Systems

Part of the book series: Health Informatics ((HI))

Abstract

Current US healthcare involves extensive use of shared electronic health records (EHRs) and other data from health information technologies for clinical care, data collection, billing and regulatory reporting. Business and regulatory processes also are dependent on EHRs and a cornucopia of other medical services, devices and platforms (wearables, home health monitors, medical imaging software, etc.). The healthcare world has created an enormous medical information infrastructure that itself has ongoing operating, maintenance and updating costs. This chapter is a first attempt to estimate the scope and magnitude of those software costs, and an invitation for others to join in the discussion.

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Notes

  1. 1.

    If instead of asking about the ROI to the government’s $36 billion in seed money, one might ask about vendors’ return on convincing the government to enact the HITECH legislation. That ROI is almost beyond calculation. Certainly, the billions of dollars returned for every dollar spent convincing the government to require hospitals and clinicians to purchase the technology was the best investment ever made.

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Acknowledgements

This effort was helped by several colleagues and friends. Catherine Mavrich did extraordinary and successful work obtaining software costs by calling hundreds of vendors, reading their materials, and sitting through too many demonstrations (before they would provide more data and sales personnel with whom to talk). She also constructed and populated the original data structure for collecting and organizing the cost data.

The editor of this volume, Dr. George Kim (Johns Hopkins), spent endless hours improving the text and the format of this work. He also served by questioning most of the numbers or requesting additional documentation. He was invaluable in suggesting additional sources and people from whom I learned much about HIT cost structures. George was, above all, a kind and encouraging editor.

Many healthcare providers were invaluable sources of information. In this category, Darren Lacey, the Chief Information Security Officer (CISO) at Johns Hopkins was invaluable in helping me obtain cybersecurity insurance costs and the increasingly shifting scope of cybersecurity insurance coverage.

Dr. Joel L. Telles, a wonderful friend and colleague, helped mightily with some of the calculations and spreadsheets. Joel had previously been a key player in analyzing data for hospital systems and hospital associations.

My colleague and friend, Dr. Stephen Soumerai of Harvard, was always urging me to include additional and important costs. Because this document is focused only on the software and implementation costs—and does not engage in the debates about HIT’s negative aspects--Steve’s advice was confined to the list of items that I excluded from the calculations. But they are serious issues that should be examined in later analyses.

I’m not going to name the many HIT vendor salespeople who spent hours with me providing numbers and cost parameters. But I’d like to thank them very much. Their information was invaluable, even if sometimes they assumed I was a potential customer. Also, I’m not going to name the leaders and others of the many associations (e.g., pharmacy associations, hospice associations, physical therapy associations, to name only a very few) because they were sometimes concerned about what was permitted to discuss about these complex money matters. But they were very helpful and even led me to others who were also knowledgeable.

My son, Jonah Koppel, was a wiz with formatting issues and with helping with the over 200 references.

Other friends and colleagues from Penn, from The University at Buffalo and from AMIA have been very encouraging about this effort, and often offered sources and insights. I thank them all.

Any errors, of course, are my responsibility.

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Authors and Affiliations

  1. Department of Sociology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA

    Ross Koppel

  2. Department of Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Ross Koppel

  3. Department of Biomedical Informatics, Jacobs School of Medicine, University at Buffalo, Buffalo, NY, USA

    Ross Koppel

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Editors and Affiliations

  1. Duquesne University, Pittsburgh, PA, USA

    Joan M. Kiel

  2. The Johns Hopkins University, Baltimore, MD, USA

    George R. Kim

  3. The University of Texas at Arlington, Arlington, TX, USA

    Marion J. Ball

1 Electronic Supplementary Material

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EHR cost data from four hospital systems (DOCX 14 kb)

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Koppel, R. (2022). Estimating the United States’ Cost of Healthcare Information Technology. In: Kiel, J.M., Kim, G.R., Ball, M.J. (eds) Healthcare Information Management Systems. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-031-07912-2_1

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