JMIR Publications

ABSTRACT

Background:

With the vast development of technology and the evolving needs of patients and healthcare providers, electronic medical records (EMRs) have become a cornerstone for health information. However, different institutions have used different EMR systems. Our study investigates the potential benefits of implementing an integrated and common platform, known as Next Generation EMR (NGEMR) in Singapore. The NGEMR allows improved data sharing between healthcare facilities and can promote better coordination between primary care and specialist care doctors to access patients’ records from the same database.

Objective:

We aim to conduct an economic evaluation of the NGEMR to inform future healthcare system upgrades.

Methods:

A cost-utility analysis comparing NGEMR with the legacy EMR was conducted using a decision tree model with a one-year time horizon from a health system perspective. The incremental cost-effectiveness ratio (ICER) was calculated using costs and quality-adjusted life-years (QALYs).

Results:

NGEMR was cost-effective and yielded a marginal health benefit (0.00006 QALYs gained) at a slightly higher cost (S$2.73), with an ICER of S$46,349 per QALY. The reduction in waiting time to see a specialist resulted in 2.3% fewer hospitalisations. The incremental cost-effectiveness ratio was sensitive to the probability of having duplicate tests.

Conclusions:

Adoption of NGEMR is cost-effective in Singapore. Beyond cost-effectiveness, the reduction of waiting time between primary and specialist care can lower the possibility of patients’ health deterioration, thus reducing hospital admission. We recommend continuous monitoring of waiting times and the likelihood of having duplicate tests as countries transition from basic to advanced-level EMR systems.