Adler-Milstein co-authors model for EHR evaluation

UMSI assistant professor Julia Adler-Milstein is co-author of a paper released on January 6, 2014, by the Institute of Medicine. The discussion paper and financial model, “Return on Information: A Standard Model for Assessing Institutional Return on Electronic Health Records,” is the product of a collaboration between participants in the Institute of Medicine’s Digital Learning Collaborative and members of the Healthcare Financial Managers Association.

In the paper, the authors propose an evaluation model to calculate the financial implications, benefits, and costs of implementing and optimizing Electronic Health Records (EHRs) and related technologies that will serve as a tool for health system management teams, and clinicians, among others. Such a model can be most useful to hospitals and health systems for inter-organizational comparisons, identifying best-in-class implementation approaches, and prioritizing process redesign endeavors, according to the Institute.

Despite the compelling policy and business environments for EHR adoption and implementation, the authors highlight common logistical and conceptual challenges that hinder investment decisions. They suggest that a standard model that allows for consistent comparison across EHR implementations could enable more useful assessments of the value of EHR systems and the re-engineering necessary to fully realize that value.

The proposed model is presented as a catalog of categorized benefits, expenses, and potential revenue impacts and the accounts where these may be captured. Features of the model include alignment of benefits with the stated goals of the Office of the National Coordinator for Health IT’s meaningful use standards, assessment of whether benefits are expected to accrue to the provider based on different reimbursement regimes, and designation of whether revenue impacts are expected to be negative or positive. Additionally, both benefits and revenue impacts are prioritized by the ability to quantify financial impact and the relative scale of financial impact.

The complete version of the model can be downloaded and examined at It is not a formal product of the Institute of Medicine, nor is it endorsed by the IOM.

Posted on Monday, January 6, 2014