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|Title:||Cost comparison of an on-premise IT solution with a cloud-based solution for electronic health records in a Dental School clinic|
|Citation:||Journal of Dental Education, 2019; 83(8):895-903|
|Publisher:||American Dental Education Association|
|Lynn Johnson, Cassandra Callaghan, Madhan Balasubramanian, Haris Haq, Heiko Spallek|
|Abstract:||Electronic health records (EHRs) are increasingly moving towards cloud-based web environments. While cloud-based EHRs claim substantial benefits at reduced cost, little cost-benefit research exists for dental schools. The aim of this study was to examine the cost-benefits of a cloud-based EHR compared to an on-premise client-server EHR in the University of Michigan School of Dentistry (U-M Dent). Data were collected in 2016 from the U-M Dent cost-benefit comparison of tangible and intangible factors associated with implementing a new EHR, using the Total Cost of Ownership (TCO) framework from EDUCAUSE. The TCO framework assessed three factors: foundational (overarching aspects: three items), qualitative (intangibles: 56 items), and quantitative (actual costs). Stakeholders performed factor grading, and relative assessment scores were derived for each item as well as the overall factor. The cloud-based EHR solution received higher foundational and qualitative factor summary scores. The overall cost of an on-premise solution over a two-year period was approximately $2,000,000 higher than a cloud-based solution. Cloud solutions did not carry any hidden costs, while such costs accounted for 8% (~$540,000) of the overall costs of the on-premise solution. Across the two-year period, both one-time and ongoing costs were higher for the on-premise solution than the cloud-based solution (by 40.5% and 20.5%, respectively). This study found that a cloud-based EHR system in the U-M Dent offered significant cost savings and unique benefits that were not available with the on-premise EHR solution. Based on cost, the U-M Dent has made a case for cloud-based EHR systems.|
|Keywords:||Dental education; dental schools; dental school clinic; clinic management; electronic health records; cost-benefit analysis; organizational innovation|
|Description:||Published online ahead of print 22 April 2019|
|Appears in Collections:||Dentistry publications|
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