EHRs: Does anyone have $105 billion to spare?

Cue the drum roll-every last one of the 8.7 million enrollees of Kaiser Permanente finally has an outpatient EHR. It’s the latest milestone of a $4 billion IT project that suggests how much it might cost to digitize theentire nation’s healthcare system.

Kaiser began rolling out its EHR, dubbed KP HealthConnect, in Hawaii in 2004 and finished up earlier this month in Northern California. While all 13,000 of its doctors in nine states and the District of Columbia can now access medical records electronically in outpatient settings, Kaiser has deployed KP HealthConnect in only 13 of its 36 hospitals. Kaiser expects the rest to beonline by 2010.

The cost of implementing KP HealthConnect through 2010 will come to roughly $3 billion, according to a Kaiser spokesperson. That’s not counting another $1 billion that Kaiser will have spent on maintaining the system through 2010.

The pricetag of Kaiser’s EHR project sheds light on what a nationwide health information network as envisioned by the federal government might cost. The population of the United States is 304 million, or 35 times the number of Kaiser enrollees. Multiply the $3 billion that Kaiser spent on implementing KP HealthConnect by 35, and you’re looking at a national tab of $105 billion.

You’d have to subtract the cost of IT infrastructure-like Kaiser’s-already in place, of course. However, you’d also have to factor in the cost of interface software to connect a multitude of disparate computer systems, which is less of an issue for Kaiser.

If anything, the Kaiser rule of thumb supplies a low-end figure. A study published three years ago in the Annals of Internal Medicine put the cost of building a model nationwide health information network at $156 billion over 5 years. That same year, the journal Health Affairs published a similar study that yielded a figure of $276 billion.

All the numbers are staggering.