Return on Investment (ROI)

For many years healthcare organizations have been attempting to determine if their investments in new technology are truly helping them become a better organization and perform more effectively?  This has always been a challenge to determine an answer for since the measurement process is so subjective and tends to be biased depending on what is being evaluated.  With clinical care systems for computerized patient records (CPR)  there are even more intangibles being evaluated for ROI which make the process of determining ROI for a CPR even more difficult.

NOA’s consultants have extensive experience with implementing numerous CPRs and know the scope of operational factors that come into play when implementing a new system.  We understand that in order to effectively measure ROI, an organization must first have a vision of what they want to accomplish with the technology investment.  From that vision, NOA is able to define metrics that help measure performance and present a clearer picture of where the organization has been operationally as well as where they are going subsequent to CPR deployment.

If you believe there is a need to know where your ROI has been realized for your CPR investment then continue reviewing NOA’s ROI solutions for your organization.

Determining how to measure return on investment can be as complex or as simple as you make it.  There is a broad range of measurement (metric) indicators that can be used to determine if you have invested wisely with new technology for a CPR.  First, you must begin with reaffirming what the organizational vision was when the CPR project was approved.  This represents essentially the goals and objectives justifying the initial investment.  Once you have clearly identified that vision, then you must begin the process of categorizing the goals and objectives as either CLINICAL or FINANCIAL.  Essentially, a CPR investment will likely be justified for purposes that seek to improve either clinical outcomes and / or financial performance.

In the past there have been flaws in measuring ROI as purely a clinical or financial venture.  The true way to effectively measure ROI for a CPR is to establish a “balanced” approach to the measurement metrics.  Having an equal number of metric indicators across both clinical and financial oriented goals can do this.

Once you define your metrics, then you have to gather data that will be used for trending analysis of organizational performance.  Due to the inability to isolate and control all extraneous factors on organizational performance outside of the ROI metrics, it is important to study ROI trends over a protracted time period.  This approach also allows for mitigating events that would otherwise skew the analysis.  One decision that an organization has to make early on in a CPR initiative is whether they want to measure metrics before and after implementing a CPR or only after initial deployment.  This decision may be influenced by whether the organization has historical data available that satisfies the measured time periods.

After you have gathered your data, it is then necessary to assign weights to each metric.  These weights determine whether the measurement values for each time period will be plotted as a favorable or unfavorable trend.  Weighing of metrics is an important step in the ROI process and will require an organization to decide whether to weigh all metrics equally or variably based on relative importance with regard to the original vision.

After assigning weights to metrics then the values derived are trended on a chart or spread sheet in order to provide a quantified image of trends that reflect an aggregated report card on organizational performance.  When you compare pre-CPR performance with post-CPR performance you can derive a much better picture of how the investment has impacted the organization.  It should be noted as well that although an organization may have had success with the initial deployment of a CPR, over time there is a potential for the operational areas to regress back into their old (pre-CPR) days of doing business which will decrease benefits derived from the CPR and subsequent ROI.  Therefore, it is also equally as important to conduct periodic ROI studies on an ongoing basis after an implementation of new technology rather than just in the early stages of a go live deployment.

As a general rule, it is important to always begin anything with the “end in mind”.  This is also true with conducting a ROI study for measuring the impact of a CPR investment.  If you do not use the original clinical vision up front to determine what the scope of the metrics should be then you have a moving target, which creates questionable results.  Through establishing solid metrics prior to making an investment for new technology you are better prepared to drive the deployment process with a sense of priorities and scope control to ensure achievement of the greatest ROI.

If, however, your organization did not identify the need for measuring ROI until after deployment of a CPR, fear not.  While you may not have known where you were going in the beginning, it is never too late to “create the vision” at any stage of the CPR initiative.  NOA can help your organization define your goals and objectives for your CPR in order to derive the necessary metrics for ROI analysis.  As long as you have historical data available to feed into the ROI analysis, it is never too late to measure where you have been and where you are going!  The only limiting factor is the availability of historical information.  If that is not available then NOA can still help your organization define what information needs to begin being aggregated for ongoing ROI analysis.  Our clinical analysts have extensive experience at knowing what to look for in operational settings in order to identify possible workflow improvements for both clinical and financial performance enhancements.

Deciding on where you go for help at evaluating a return on investment for something as significant as a CPR is a very important decision.  Many organizations will turn to the large consulting firms who typically only have general knowledge about a CPR.  While these firms may have good reputations for some types of consulting engagements, they do not typically possess the expertise for evaluating a computerized patient record that occurs as a result of deploying multiple CPRs in numerous healthcare settings.  Negley, Ott & Associates, Inc. (NOA) has developed a specialty practice around the deployment of CPRs for the past 10 years at over 35 hospitals across the United States and Canada.  In addition, our clinical skills and workflow knowledge of healthcare operations provides a core competency for prescribing and measuring process improvements associated with implementing a CPR.

Based on our company’s experience over the past 18+ years with deployment of computerized patient record systems and software, the best approach to measuring return on investment is one where there is an even balance across both clinical and financial performance indicators.  If you focus on only one area or the other,  your findings will be skewed and thus reflect an inaccurate picture of the true impact the CPR initiative has had on your organization.  During the course of a CPR deployment and subsequent ongoing management of the system, there will be peaks and valleys in the benefits derived.  Many of the peaks and valleys are also influenced by other extraneous “non-CPR” initiatives occurring simultaneously within your organization.  By having a balanced approach to measuring specific metrics across both clinical outcomes management and financial bottom line, you can maximize the accuracy and stability of your measurement process

Subsequent to measuring indicators and determining operational trends, NOA is prepared to introduce a “BUSINESS CASE DEVELOPMENT” model.  This model consists of a process for evaluating system enhancements, purchases and modifications that would result in a significant investment of time, materials or resources (a.k.a. money) in order to achieve the new functionality, etc.  Through establishing a standard set of rules to measure new systems or functionality by, it helps quantify ROI expectations up front and organizations are better prepared to manage implementation of new systems in a manner that is more capable of achieving ROI based on original expectations.

NOA’s approach to ROI is both quantitative and process-oriented which helps transform an organization from just purchasing and implementing systems to an organization that achieves expected clinical outcomes and financial performance through implementation methodologies for computerized patient records.