Table 2.

Crude return on investment summary for electronic medical record implementation. All currency is presented in Canadian dollars.

			Initial	2010/11	2011/12	2012/13	2013/14	2014/15
Capital/one-time investment/implementation
	Initial investment and implementation cost		6,546,274	—	—	—	—	—
	Staffing		4,135,900	—	—	—	—	—
	Total initial investment		10,682,174	—	—	—	—	—
Operational costs (incremental)
	Incremental IT/CIa staffing		—	563,768	871,960	881,933	873,036	864,333
	Maintenance and support—EMRb		—	173,093	289,059	270,811	329,293	333,388
	Incremental hardware, software, and licensing		—	24,864	14,215	77,512	17,264	428,481
	Total expenses		—	761,725	1,175,234	1,230,256	1,219,594	1,626,202
Hard return on investment
	Savings/efficiencies
		HIMc paper chart savings	—	15,000	20,000	25,000	25,000	25,000
		HIM chart control staff Reduction	—	—	185,865	200,630	209,831	341,885
		Transcription service savings	—	—	101,280	107,955	97,969	118,071
		Lab test utilization	—	—	—	—	16,372	16,372
		Reduced clerical and admin overhead	—	150,000	153,000	156,060	159,181	162,365
		Reduction in medication cost due to unit dose and utilization	—	196,078	200,000	204,000	208,080	212,242
		Staff savings from restraint and seclusion prevention	—	—	—	—	776,633	666,957
		Reduction in antipsychotics due to CPGd	—	—	—	—	—	12,240
	Revenue/incentives
		Grants	—	—	—	—	50,000	216,563
Soft return on investment
	Cost savings/avoidance
		Adverse drug event	—	—	—	38,100	38,100	50,800
		Annual benefits	—	361,078	660,145	731,745	1,581,166	1,822,494
		Total annual cash flow	(10,682,174)e	(400,647)e	(515,0789)e	(498,511)e	361,573	196,293

^aIT/CI: information technology/clinical informatics.

^bEMR: electronic medical record.

^cHIM: health information management.

^dCPG: clinical practice guideline.

^eParentheses indicate deficit.