Emergency department information system implementation and process redesign result in rapid and sustained financial enhancement at a large academic center.
Emergency department information system implementation and process redesign result in rapid and sustained financial enhancement at a large academic center.
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急诊科信息系统的实施和流程的重新设计导致大型学术中心的财务状况快速持续地增强。
DOI：
10.1111/j.1553-2712.2010.00720.x
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Richardson,LynneD
中科院分区：
文献类型：
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作者：
Shapiro,JasonS;Baumlin,KevinM;Chawla,Neal;Genes,Nicholas;Godbold,James;Ye,Fen;Richardson,LynneD
目的：目的是衡量实施一个完全集成的急诊科信息系统（EDIS）的财务影响，并确定时间的长度，以“收支平衡”的初始investment.Methods：一个之前和之后的研究设计进行了分析的框架，包括四个15个月的阶段：1）实施前，2）实施后，3）postimplementation，和4）持续的影响。对登记和财务数据进行了审查。成本和专业和设施的收费和收据率计算的阶段，并与每月平均协变量，如量，收集率，敏锐度，年龄，入院率，保险状态与自回归时间序列分析使用分段模型进行比较。盈亏平衡点的计算方法是：测量最后三个研究阶段的累计月收入超过实施前阶段的平均月收入，并根据数量变化进行校正，然后将其与累计总成本进行绘图。结果：EDIS初始投资的盈亏平衡时间不到8个月。 在5年研究期结束时，总收入增加为16，138，953美元，费用增加69.40%，收入增加70.06%。这相当于每名病人的专业服务收入从50美元增加到90美元，设施收费从131美元增加到183美元。除数量外，实施前和持续效应期之间的协变量趋势没有显著变化。结论：通过重新设计流程，全面实施EDIS，可持续增加专业和设施收入，并快速实现初始盈亏平衡点。学术急诊医学2010; 17：527-535 © 2010，由学术急诊医学学会提供
Objectives:The objectives were to measure the financial impact of implementing a fully integrated emergency department information system (EDIS) and determine the length of time to “break even” on the initial investment.Methods:A before‐and‐after study design was performed using a framework of analysis consisting of four 15‐month phases: 1) preimplementation, 2) peri‐implementation, 3) postimplementation, and 4) sustained effects. Registration and financial data were reviewed. Costs and rates of professional and facility charges and receipts were calculated for the phases in question and compared against monthly averages for covariates such as volume, collections rates, acuity, age, admission rate, and insurance status with an autoregressive time series analysis using a segmented model. The break‐even point was calculated by measuring cumulative monthly receipts for the last three study phases in excess of the average monthly receipts from the preimplementation phase, corrected for change in volume, and then plotting this against cumulative overall cost.Results:Time to break even on the initial EDIS investment was less than 8 months. Total revenue enhancement at the end of the 5‐year study period was $16,138,953 with an increase of 69.40% in charges and 70.06% in receipts. This corresponds to an increase in receipts per patient from $50 to $90 for professional services and $131 to $183 for facilities charges. Other than volume, there were no significant changes in trends for covariates between the preimplementation and sustained‐effects periods.Conclusions:A comprehensive EDIS implementation with process redesign resulted in sustained increases in professional and facility revenues and a rapid initial break‐even point.ACADEMIC EMERGENCY MEDICINE 2010; 17:527–535 © 2010 by the Society for Academic Emergency Medicine