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Worksheet 1Worksheet 2`^Worksheet 3?Worksheet 4*Worksheet 5 ~Worksheet 6:#XNPV2!NPVInfo;"P"3 @@+~pEnter the item's annual cost, such as its maintenance cost, licensing fee or other recurring charges during the first and subsequent years. Costs for the first year may be different than subsequent years for items under warranty. For example, the firstyear maintenance costs for the items "Servers" and "Data Storage" in the sample spreadsheet are 75 percent of what they will be in the subsequent years because they have 90day warranties. The laptop computers in the sample carry a sixmonth warranty so their firstyear cost is half of what it will be in subsequent years. The spreadsheet calculates the fiveyear cost of the system by adding the first year's cost to the succeeding year's cost multiplied by four (i.e., Year 1 + (Years 2 through 5 x 4)). The spreadsheet estimates the net present value (i.e., the cost in today's dollars) of the EMR system. This will help you determine what it will really cost you to own and operate the EMR system during the first year and over the fiveyear period. Although the default discount rate is set at 8 percent, this spreadsheet will allow you to enter different discount rates. The dates for paying the initial cost is currently set at Jan. 1 and the dates for paying annual costs are set at July 1. Again, the working copy of the spreadsheet allows you to enter different dates. NOTE: The initial date is generally considered the date that the EMR system is installed.*If the Net Present Value doesn't calculateqThe function used here to calculate net present value is available in the "Analysis ToolPak," an addin to Excel.iThe Analysis ToolPak may already be on your computer but not selected as an addin. To make it available,follow these directions:To install the Analysis ToolPakeIf Analysis ToolPak is not listed in the AddIns dialog box, you must first run the installer program^that you used when you originally installed Microsoft Excel, and install the Analysis ToolPak.#Then select it in the AddIns list.WNote: Addins you select in the AddIns dialog box remain active until you remove them.,If the net present value doesn't calculate & Back to worksheet(Staff to scan in data from other sources$1. On the Tools menu, click AddIns.)2. Select the Analysis ToolPak check box.Net present value Date paidAmount paidpercent How to use this spreadsheetFor each item, enter a brief description, its unit cost and the quantity needed. The spreadsheet calculates the extended cost of the item by multiplying the unit cost by the quantity. 3Fiveyear cost of EMR system with discount rate of Annual and fiveyear costsUpgrades'Calculating the Costs of an EMR System jNote: vendors price software licenses in a variety of ways, e.g., per physician, per site, per workstationUpgrades may be included in software support services below or charged separately. If charged separately, estimate number of upgrades and allocate cost over first five years8May also include network, telecommunications, electricalIncludedQuestions to ask vendorsDeveloped by Jack Valancy, MBA, Jack Valancy Consulting, Cleveland Heights, Ohio. Copyright 2002 American Academy of Family Physicians. Staff travelVendor staff time9May include scanning or keying in data from paper recordsFiveyear EMR system costTotal cost of EMR systemTOTAL: HardwareTOTAL: SoftwareTOTAL: Vendor supportTOTAL: Other considerationsHardware Unit costQuantity
Extended costData storage5year costElectricianMain server
Backup serverDesktop computersLaptop computersLaserInkjetScannerCable installation ?May also include cost of installing wireless network componentsHMay also include cost of Internet service provider, voice and data linesUninterruptible power suppliesCommentsHow to Use This WorkbookPlease read the following instructions before using the workbook. To view a completed spreadsheet, click on the tab labeled "Sample" below. To enter your own data into a working copy, click on one of the tabs labeled "Worksheet" below. (You can use each worksheet to enter information on a different EMR system.) You can obtain additional information or instructions by holding your mouse over any cell that has a red triangle in the upper right corner. 9May be included w/ servers above or as separate component0Clientserver or peer network w/ one or more PCsmodems, multiplexorsInitialYear 2Year 3Year 4Year 5 Years 25Servers
Input devices
ElectricalSoftwareOther considerationsOngoing data entry"Hardware and software installation
RAID arrayDAT drive and cartridgesRouter & switchesDSLUnixEMR applicationInterface modules_May also include cost of installing dedicated electrical circuits or power protection equipmentYThe spreadsheet computes the costs for purchasing an EMR system. It does not address financing or leasing options because these involve working capital and tax implications unique to each practice. If you're interested in financing or leasing, consult with a qualified accountant for advice on the alternative most appropriate for your practice.Data backupPrinters
Other devicesSite preparationNetworkTelecommunicationsDescriptionOperating systemApplicationsVendor supportTrainingData conversion$Interface(s) with other applicationsYear 1Initial cost2Available at www.aapf.org/fpm/20020400/57howm.html2Available at www.aafp.org/fpm/20020400/57howm.htmlZPhysicians may use in their practices to evaluate EMR systems. All other rights reserved. \"How Much Will That EMR System Really Cost?", Family Practice Management, April 2002:5758. %
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