Kathryn Lofton

FEASIBILITY STUDY
IMPLEMENTING AN ELECTRONIC HEALTH RECORD FOR OUR PRACTICE

DESERT HEALTH SERVICES

April 21, 2016

Kathryn Lofton

TABLE OF CONTENTS
1.

EXECUTIVE SUMMARY ____________________________________________3

2.

BACKGROUND ____________________________________________________3

3.

SYSTEM OVERVIEW _______________________________________________3

4.

TECHNOLOGICAL FEASIBILITY _____________________________________3

5.

ORGANIZATIONAL FEASIBILITY ____________________________________4

6.

FINANCIAL FEASIBILITY ___________________________________________4

7.

SCHEDULE ________________________________________________________5

8.

FINDINGS AND RECOMMENDATIONS ________________________________6

Kathryn Lofton

1. EXECUTIVE SUMMARY
This feasibility study covers the implementation of an EHR for our practice. We will
consider many aspects, among them cost, technical requirements, staff requirements, and an
approximate schedule for this project.

2. BACKGROUND
This project is concerning the implementation of an EHR for our practice. This study will
give a brief synopsis of the technical options of cloud vs client-server system, costs over 5 years,
staffing needs, and schedule. The associated costs as well as return on investment are found in
the Financial Feasibility section.

3. SYSTEM OVERVIEW
There are two ways an EHR can be implemented, a cloud or a client-server system. A
majority of private practices choose cloud technology due to the lower up-front costs. All that is
required is an Internet connection and simple computers. A client-server system will require a
secure area for the equipment. A method of backing up the data will also need to be in place in
the event of a disaster or hardware/software failure. The ability to download patient data and
storage requirements will need to be considered in a cloud-based system.

4. TECHNOLOGICAL FEASIBILITY
Probably the best option for our practice would be a cloud-based system. This would not
require additional space for equipment. The cost for the system itself would be more in the long
run, but the cost could be offset by remaining in our current space, although some of the space
currently occupied by paper chart storage could possibly be renovated into a secure area for the
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Kathryn Lofton

server hardware required. A client-server system would require either moving to a larger space
or renovation to add a secure area to house the equipment, with either a higher lease expense or
renovation expense.

5. ORGANIZATIONAL FEASIBILITY
If a cloud-based system is used, the changes involved will be pretty much equipping
exam rooms, front desk, back office, and physician offices with fixed or wheeled terminals,
giving staff tablets or notebook computers to carry with them, or a combination of mobile and
fixed equipment. Printers will also be required in front and back office, regardless of the use of
stationary or mobile equipment. If a client-server system is used, secure space will be necessary
for location of hardware. It is possible some of the space currently used for paper chart storage
could serve this purpose as the need for storing paper charts will decrease. Staff will need to be
educated and evaluated on their ability to use computers and get them comfortable with the idea.
Staffing number will probably not change significantly following installation and
implementation, but job descriptions of some staff members may be changed. For example,
transcriptionists and/or medical assistants may need to take on more scribe duties as the need for
transcription will reduce.

6. FINANCIAL FEASIBILITY
In-Office

In-Office

In-Office 5-Year

Cloud-Based

Cloud-Based

Cloud-Based 5-

Estimated

Estimated

Total Cost of

Upfront Cost

Yearly Cost

Year Total Cost

Upfront Cost
$33,000

Yearly Cost
$4000

Ownership
$48,000

$26,000

$8000

of Ownership
$58,000

Based on November 2014 estimates

Kathryn Lofton

Initial Cost
($13,100)

Present

Year 1
($8190)

Year 2
$19,229

Year 3
$12,612

Year 4
$38,832

Year 5
$36,982

value of net
benefit
(cost)
Five-Year Return on Investment Per Provider for Electronic Medical Record Implementation

7.

SCHEDULE
Note that much of the timeframe will depend on the EHR vendor. The estimated times
given are subject to change.

Evaluation of job requirements of staff members and how each would use the EHR.
Evaluate clinical and cross-departmental workflows. Evaluate technical skills of each

staff member using the system 30 days

Decide on EHR vendor. Determine a Go-Live date with vendor and carry out weekly

meetings to check progress, once a vendor decision is made 90 days

Evaluate infrastructure and build interfaces 60 days
Implementation Depends on EHR vendor timeframe
Installation and training Depends on EHR vendor timeframe
Issues resolution 60 days

The approximate goal, from contract signing date to Go-Live is 9 months.

Kathryn Lofton

8. FINDINGS AND RECOMMENDATIONS

The addition of an electronic health record will be beneficial to our practice. It will reduce
the need for paper chart storage and duplication of lab tests and other diagnostics. This will also
save time as updates to patient demographics and history will be streamlined. If we begin to get
physicians and staff comfortable and accepting of an EHR and understand their needs and
expectations of the system now, the choice of the EHR vendor and features that will meet our
needs will be easier and give us what we need. The main concern is initial cost as well as
continued costs for upgrades. Taking the time to find the system that suits us best based on
features included in its cost and cost of add-ons will help with getting an accurate estimate of the
costs involved over 5 years. Security concerns will be addressed during vendor evaluation.

REFERENCES
HealthIT.gov. (n.d.). Retrieved February 13, 2016, from https://www.healthit.gov/providersprofessionals/faqs/how-much-going-cost-me
Wang, S., MD, PhD, Middleton, B., MD, MPH, Prosser, L. A., PhD, Bardon, C. J., MD, Spurr,
C. D., RN, MBA, Carchidi, P. J., RN, MPH, . . . Bates, D. W., MD, MSc. (2003, April 1). A CostBenefit Analysis of Electronic Medical Records in Primary Care. Retrieved February 13, 2016,
from http://nyehealth.org/wp-content/uploads/2012/07/Wang_EMRCostBenefit.pdf