Administration
Data stored within the HELP clinical system has been used in the Utah Intermountain Health Centre to evaluate the costs and quality of care for a variety of medical and surgical procedures. The EMR provided information on variations in length of stay, surgical procedure time and costs for uncomplicated surgical resections of the prostate. This information was relayed to the medical practitioners who performed the operations in a range of institutions and they co-operated in altering their surgical techniques and procedures to reduce the mean length of stay and costs of routine Transurethral Resections of the Prostate (TURP) (James 1989). In the evaluation process it was found that certain preoperative procedures such as chest X-rays, were unnecessary if a patient had an uncomplicated medical history. The same clinical data generated from the patient care process is being used to measure and evaluate the effectiveness of Diagnostic Related Group (DRG) studies, and has led to a reduction in DRG costings. Similar hospitals not using a patient-based EMR system have expanding DRG and other health costs (Gardia 1994). This confirms Howard Bleich’s observation that 90% of administrative cost data can be generated as a by-product of the patient care process (Bleich 1985).