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Table 4 Overview of cost data and cost outcome of model-based studies (n = 4)

From: Economic impact of clinical decision support interventions based on electronic health records

Study

Model time horizon (years)

Choice of model

Implementation and maintenance costs

Total budget impact

ICER

Gong et al. [5]

30

Markov model

$1.91 base case for 100,000 individuals [preexisting EHR]

CDS intervention

$17.32 mill.

Control

$17.82 mill.

$99.8 per QALY in base case scenario

Sharifi et al. [26]

10

Monte Carlo micro-simulation

$23,542 per PCP group [preexisting EHR]

CDS intervention

+$239 mill.

$237 per BMI unit reduction

Michaelidis et al. [33]

5

Decision analytic tree

$18 base case - medical record programming [preexisting EHR]

CDS intervention

$2802a

Control (usual care)

$2768a

$51.51 per antibiotic prescription safely avoided

Forrester et al. [35]

5

Decision analytic tree

$1,773,000

5 years CPOE system cost

CDS CPOE system

$25 mill.

Control (paper system)

$43mill.

$110 per ADE avertedb

  1. aCumulative 5-year societal cost per five cases of acute bronchitis
  2. bDocumented only for the explored modelling scenario no. 2: The Everett Clinic achieved no reduction in paper chart pulls throughout the 5-year time horizon, to explore the effect of inefficiency from running a paper and electronic system in parallel