According to a study published in HealthAffairs on Mar 4, just 27 percent of practices achieved a positive return on investment five years after implementation of electronic health record (EHR) systems. The study analyzed survey data from community practices in a large EHR pilot called the Massachusetts eHealth Collaborative.  Based on analysis of the forty-nine participating practices, the average physician would lose $43,743 over five years. 

The HealthAffairs study also analyzed why some practices were more successful with EHR implementation.  Practices with a positive return on investment saw more patients per day, improved billing to result in fewer rejected claims, and used more accurate coding.  Positive return on investment (ROI) was also found to be tied to practice size.  36 percent of practices with six doctors or more had a positive ROI, while only 26 percent of practices with one or two doctors had a positive ROI.  The study encouraged the federal government to pursue policies to reduce the cost of EHR adoption and increase its benefits.