Financial Modeling For Your Electronic Health Record

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By Barbara C. Robbins and Howard C. Werner. Originally published in the December 2003 issue of Advance for Health Information Executives.

The business of healthcare requires that executive management look closely at capital expenditures to justify expenses affecting the bottom line. As healthcare organizations move increasingly toward implementing information technology (IT) to improve overall communication, process efficiency, and patient care, financial considerations require that facilities document the return-on-investment (ROI). Healthcare facilities are increasing the use of Electronic Health Records (EHRs) and administrators must rely on financial modeling and analysis to document the investment in the clinical and business practice.

Healthcare Management
Healthcare expenditures have skyrocketed in the last decade. U.S. healthcare spending is currently $1.4 trillion according to the Health and Human Services Department. Hospital and prescription drug spending are responsible for a large portion of this expense. To manage this big business, facilities must rely on increased productivity and profitability. Today, executives must closely manage efficiency in work process, productivity in treatment delivery, cost containment in the business practice, and positive returns on any capital expenditures, including an EHR investment.

Implementing EHR Technology
The rise of electronic systems to manage patient care came in large part due to medical reports released from the Institute of Medicine (IOM) and Leapfrog Group documenting the efficacy of EHRs to pinpoint medical errors and enhance patient safety. Recent regulatory mandates, such as the Health Insurance Portability and Accountability Act (HIPAA), have also contributed to the increased use of EHR patient information management systems.

While the healthcare industry has increased IT spending relative to other business sectors, only 20% of the healthcare provider facilities have an EHR that combines an integrated computerized physician order entry (CPOE) capability and medication administration record (MAR) component that simultaneously captures the patient information and practice management aspects. The qualitative benefits of using an EHR are well understood and its use is widely accepted as a way to improve patient care and benefit the business of healthcare, yet 80% of facilities are trying to answer the question of whether or not a fully integrated EHR is a financially sound investment for their facility.

There are three steps a facility should embrace when implementing an EHR:
1) Identify the problems to address in order to determine the amount of capital investment. Identify the required outcomes and progressively work towards these goals—beginning with the end in mind.
2) Develop a quasi-partnership with healthcare professionals experienced in implementing an EHR and leading change.
3) Monitor and document the qualitative and quantitative return prior to implementation and at intervals during and after the implementation.

Approaching ROI for EHRs
Traditionally, healthcare executives and administrators have not examined the value of implementing an EHR in a rigorous way. Most have accepted the system based on the inherent advantages it provides. Some may have gathered ROI through historical data
to track trends, but few or perhaps none have applied a financial modeling tool that identifies the internal rate of return (IRR) or net present value (NPV) to project ROI.

Another ROI approach is to capture the productivity of the business practice through EHR implementation and use. While the benefits to patient care are obvious, implementing a system can be challenging. A healthcare professional’s learning curve can slow the way patient treatments are ordered, documented, and communicated, and software development and upgrades can delay the rollout of new features and benefits. Achieving a positive ROI during an EHR implementation is a continual goal that must be recognized by the business of delivering healthcare.

The methods used to identify the ROI financial modeling tools
are presented in three different approaches: historical data
tracking analysis, IRR and NPV calculations, and productivity and quality return.

The Benefit of ROI
Whether institutions are faced with contemplating if and when to implement an EHR or are plodding ahead or even persevering with a formal project management approach with timelines and designated resources, the bottom line is that the EHR is a standard operating procedure in the patient record world.

In order to competitively position healthcare practices for clinical safety, communication, global access to patient information, as well as recruitment and retention of staff by providing efficient and reliable patient information management systems, it is imperative to recognize the positive aspects of an EHR return-on-information and return-on-investment. Facilities must quantify the benefit to the bottom line. The EHR is not categorized as an expense if the business practice can demonstrate its validity as an investment to the work processes, revenue generation, and cost containment.

ROI – Historical Data Tracking Analysis
Many administrators use historical data tracking trend analysis when performing EHR ROI. 7-11 What do we look at when we asked for an analysis of the proposed cost and the impact on the business practice?

Figure 1 is an example of a historical data model that can capture your return on information. This model has basic assumptions that link to the cells within the model. As real data is entered into the assumptions, the model will capture your return on information. The model spans four years: the year before the implementation, the year during the initial phase of implementation, and the first full year of use with integrated modules of the EHR capabilities. A fourth year is added to capture the use of all the integrated modules of the technology.

It is important to first look at what exists today or before the implementation of the EHR. The sheet lists various situations, like number of FTE nurses, or number of patient visits/month over various intervals. To ease the analysis and account for various fluctuations, divide the yearly number by 12. The historical data tracking analysis highlights four questions that can be answered in the areas of consideration:

1. What existed initially?
2. What needed to change?
3. What changed?
4. What are the identified benefits or weak areas in the practice or facility?

ROI – IRR and NPV
In financial management, ROI is usually thought of as the percentage outcome of the ‘Return of the Purchase’ divided by the ‘Initial Investment’.12,13 In the business sector the ROI is essentially the same equation but the dividend is the ‘Profit’ and the divisor is the ‘Source of Capital’. When calculating the ROI over a number of years the ROI must be calculated in terms of the present value (PV) of dollars so the formula must have the added component of the discounted cash flow (DCF) or sometimes referred to as the discount rate. Dollars in one year or several years to the business practice must be identified in today’s dollars or the PV of dollars.

The initial equation to apply in calculating the ROI through readily identified financial management terms is:
ROI = Return/Initial Investment

When taking into consideration the ‘Return’ becomes available over a period of the time, the term ‘Return’ becomes the net present value (NPV). The ROI equation essentially becomes:

ROI = NPV/Initial Investment

The NPV yields informational value of the excess received from the investment or the profit, which is over and above the initial capital investment. The NPV equation is the accumulated return and subtracts for the initial investment. The NPV equation is further broken down to the equation of:

NPV = -C + å

                                        1+ r^t

The variable (-C) is used to represent the initial investment or cost at the current PV of dollars. The initial EHR investment figure is added to the sum of the payments (negatives) and income (positives) each year. The sum of the negatives and positives is divided by the DCF represented by the variable ‘r’ with a ‘t’ exponent with ‘t’ representing the length of time.12

When applying this model, the challenge becomes what to identify as the payments and income each year. Figure 2 gives an example of the ROI EHR template model that yields the NPV and the Internal Rate of Return (IRR). Incorporating the IRR into the NPV model can give a comparative analysis of other investment opportunity considerations.

ROI – Productivity & Qualitative Return
Identifying the productivity of the facility is yet another ROI method of an EHR investment, which examines the ROI analysis more closely and accordingly provides a more complex spreadsheet. Often executive management in practices and facilities express the need and want for EHR capabilities but the difficulty lies in articulating the actual benefits to the business practice.

The model in Figure 3 is a workbook template with basic assumptions of the healthcare practice. The first sheet, Analysis Considerations lists quantitative and qualitative items and denotes changes and trends over the years. The Analysis Considerations are applied after first calculating the productivity factor. The next spreadsheet, Transforming the Return on Information into the Return on Investment is made up of the assumptions within the financial model. The EHR productivity in this spreadsheet is a template that calculates the bottom line of the productivity each year.

According to the Bureau of Labor Statistics, since 1995 productivity in the United States has increased at an average annual rate of two percent. Often with the implementation of EHR, the standard financial ROI with the NPV cannot be fully calculated--as this technology has qualitative findings. Initially the ROI may be in the form of qualitative returns or a positive return-on-information.

The productivity model has a basic concept noted from an incorporated formula to equate the Total Factor Productivity (TFP), which is an algorithm used in research to offer an explanation as to why some countries are wealthier and continue to grow wealthier, due to their implementation of technological progress. 14 Research analysts have calculated the formula with Fortune 100 companies. This template takes the TFP formula a step further and is applied within a financial model for a healthcare practice. The model has basic assumptions. The cells are linked within the assumptions to the financial model spreadsheet so that individual facilities can apply their own numbers into the assumptions in order to evaluate their productivity factor and other financial leverage aspects.

The productivity analysis yields a percentage. It is important to further understand and identify the area(s) contributing to the productivity or lack of productivity. The Analysis Considerations provides a method to identify what has changed and is a tracking tool to capture both quantitative and qualitative documentation. The productivity is related to revenue, assets, and consideration of the investment in technology as the outcome of productivity. Usually productivity is configured with labor and productivity is considered the output of labor. However, the labor factor does not give credence to the money invested in technology and therefore the outcome of applying technology to increase the aspect of productivity provides the rationale that productivity is due to both labor plus technology.

Upon evaluating the productivity factor, the Analysis Considerations spreadsheet is used to identify the rationale for the outcome of this productivity factor. The answers to realizing the quantitative and qualitative ROI of EHR through productivity lie first with identifying where this productivity is coming from. This model can also be used to apply this formula in a regression analysis or a global view of past occurrences.

Embracing the EHR
By continuing to solve our work process challenges within our own comfort zone, we often find ourselves using the same approach used in the past. Fear of change or stepping out of our comfort zone prevents the use of an application that can provide continual advances in better methods to accomplish our work.15, 16 Innovation and advances in EHR technology are opportunities for the healthcare administrator to better lead the practice with increased productivity and adherence to regulation while striving to enhance and streamline patient care.6

As EHR technology gains widespread adoption as a standard operating procedure, we must continue to strive for ongoing improvements in the work process with cost containment, positive ROI, and patient care delivery with quality, efficiency, and accuracy. Giant leaps in proactively managing the business of healthcare delivery can be made when we combine an efficient integrated EHR solution encompassing electronic patient charting, CPOE, MAR, and practice management with rigorous ROI modeling to identify the positive qualitative and quantitative outcomes.
 

Julie DeSantis
Public Relations Manager
IMPAC Medical Systems, Inc.
650-623-8883
pr@impac.com
http://www.impac.com

 
©2003 IMPAC Medical Systems, Inc.

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