Survey of EHR Cost Components

1. What is your access code?

This is a 6 character long code (text or number) that you used to enter data. You must enter exactly same access code, otherwise your responses will not be linked together. 

2.  In this survey, we ask you for the budget related to EHR services during a particular fiscal period.  We are interested in the most recent fiscal period about which you have information.  Please enter the start date of the most recent fiscal period using the format MM/DD/YYYY. 

4. Enter the end date of the most recent fiscal period using the format MM/DD/YYYY.

5. During the most recent fiscal period, what was the total number of clients served by the EHR services.  See a worksheet on how to calculate the number of clients served from recent admissions. 

6.  During the most recent fiscal period, what was the total number of visits during which an EHR service was used.  See a worksheet on how to calculate number of visits.  Please note that the number of visits should exceed or be the same as the number of patients. 

6. Enter personnel costs of the EHR services in the five years starting with planning to implementation to use of the EHR.   Include contractual as well as direct costs.  Personnel costs for EHR can be estimated from the organization's budget proportional to the number of FTE staff working on various aspects of EHR.

 
Total personnel costs in year 1

Total personnel costs in year 2

Total personnel costs in year 3

Total personnel costs in year 4

Total personnel costs in year 5

7. During the most recent  fiscal period, what would have been the estimated cost of volunteer services, if the EHR services had to pay for these volunteers.  Enter 0 if there were no volunteer services.

$ per year

8.   During the most recent fiscal period, what was the estimated amount of material and supplies used by the EHR services.  Include both donated and purchased materials. 

$ per year

9.  Enter the cost of building used to deliver the EHR services.  Include any building or facility that was used by the EHR staff.   Include the market value of space donated to the program.   Adjust the usage by the percent of time the space was used by the EHR services.  See a worksheet on how to calculate the cost of building.

10.  What is the equivalent yearly lease for the equipment used by the EHR services.  Include yearly lease value for (1) office furniture for example chairs, desks, filing cabinets, tables, & other, (2) computers, printers and fax machines, (3) electronic equipment other than computers for example, TV, VCR, projectors, phones, copy machines, security systems, and (4) Medical equipment for example equipment used in testing system operations.  Include the market value of donated equipment.  See a worksheet on how to calculate the cost of equipment.

11.  What was the total cost of occupancy of the EHR services.  Include electricity, gas, oil, water, sewer, trash, garbage collection, property insurance, maintenance, minor repairs, pest control, federal taxes (estimated if not paid), state taxes (estimated if not paid), local taxes (estimated if not paid), vehicle expenses including gasoline, tires, batteries, maintenance, insurance, registration. Include other miscellaneous cost of operating a business but not the cost of licensing of medical records.

12.  What is the cost of software licenses for the clinicians working with the EHR?  See a worksheet on how to calculate the cost of licensing of EHR. 

This ends the data needed for conducting a cost analysis of the EHR.  Submit the data to receive an analysis of the data.