According to a study, recently appearing in an issue of the journal Health Affairs,  implementing an electronic health record (EHR) could to lead to revenue loss. The authors of the report studied 49 community practices in a large EHR pilot through the Massachusetts eHealth Collaborative, and found that the average physician lost $43,743 over five years and just 27 percent of practices would have achieved a positive return on investment.

The researchers said that “only” an additional 14 percent of practices would have come out ahead had they received the $44,000 federal meaningful-use incentive. According to the researchers, “the largest difference between practices with a positive return on investment and those with a negative return was the extent to which they used their EHRs to increase revenue, primarily by seeing more patients per day or by improved billing that resulted in fewer rejected claims and more accurate coding.”

The survey’s authors said meaningful use incentives alone would not likely achieve a positive return on investment from EHR adoption. Most smaller providers, they reported, would need help from a regional extension center program.

In a press conference at the Healthcare Information and Management Systems Society (HIMSS), Farzad Mostashari, M.D., National Coordinator for Health IT, responded to the survey’s findings, saying the cost of EHR implementation isn’t realistically portrayed in the survey,

“The first study was kind of a sister project of mine, Massachusetts eHealth Collaborative, that basically covered all the costs for software, hardware, and support, for these practices in Massachusetts. So there was no price sensitivity in this,” Mostashari says. “In fact, providers in the real world are very price-sensitive. So the context of that study is important but not really generalizable. They’re saying it costs $137,000 per physician for hardware, software, and physician support. In this day and age, it would be hard to find comparable cost comparisons with that study.”