national health information network

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Ann Intern Med. 2005 Aug 2;143(3):165-73.

The costs of a national health information network.
===================================================

Kaushal R, Blumenthal D, Poon EG, Jha AK, Franz C, Middleton B, Glaser
J, Kuperman G, Christino M, Fernandopulle R, Newhouse JP, Bates DW;
Cost of National Health Information Network Working Group.

Brigham and Women's Hospital, Institute for Health Policy,
Massachusetts General Hospital, Partners Healthcare System, Harvard
School of Public Health, and Harvard University, Boston, Massachusetts
02120, USA. rkaushal@partners.org

Comment in:

Ann Intern Med. 2005 Aug 2;143(3):227-8.

Ann Intern Med. 2006 Jan 17;144(2):145; author reply 147.

Ann Intern Med. 2006 Jan 17;144(2):145; author reply 147.

Ann Intern Med. 2006 Jan 17;144(2):146; author reply 147.

Abstract

BACKGROUND: The use of information technology may result in a safer
and more efficient health care system. However, consensus does not
exist about the structure or costs of a national health information
network (NHIN). OBJECTIVES: To describe the potential structure and
estimate the costs of an NHIN. DESIGN: Cost estimates of an NHIN model
developed by an expert panel. SETTING: U.S. health care system.
MEASUREMENTS: An expert panel estimated the existing and the expected
prevalence in 5 years of critical information technology
functionalities. They then developed a model of an achievable NHIN by
defining key providers, functionalities, and interoperability
functions. By using these data and published cost estimates, the
authors determined the cost of achieving this model NHIN in 5 years
given the current state of information technology infrastructure.
RESULTS: To achieve an NHIN would cost 156 billion dollars in capital
investment over 5 years and 48 billion dollars in annual operating
costs. Approximately two thirds of the capital costs would be required
for acquiring functionalities and one third for interoperability.
Ongoing costs would be more evenly divided between functionality and
interoperability. If the current trajectory continues, the health care
system will spend 24 billion dollars on functionalities over the next
5 years or about one quarter of the cost for functionalities of a
model NHIN. LIMITATIONS: Because of a lack of primary data, the
authors relied on expert estimates. CONCLUSIONS: While an NHIN will be
expensive, 156 billion dollars is equivalent to 2% of annual health
care spending for 5 years. Assessments such as this one may assist
policymakers in determining the level of investment that the United
States should make in an NHIN.

PMID: 16061914 PubMed - indexed for MEDLINEFree Article

Publication Types, MeSH Terms
-----------------------------

Publication Types:

Research Support, Non-U.S. Gov't

MeSH Terms:

Health Expenditures

Health Facilities/economics

Humans

Information Services/economics

Medical Records Systems, Computerized/economics

Models, Theoretical

United States

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