Preparing a budget is often a complex organization-specific process.  Health IT, as a capital investment that impacts many aspects of a healthcare organization, often requires a structured budgeting process that integrates with the enterprise-wide organizational planning.  The scope of the implementation will directly impact the budgeting process.  CAHs and small rural hospitals often will need to consider the impact of the health IT implementation on other needed improvements in other hospital departments.  Similarly, ambulatory providers will need to consider how the cost of the health IT implementation will affect other capital funding needs, such as purchase of non-health IT equipment. 

The budgeting process should prioritize areas that will make the most impact.   For example, a hospital may find that implementation of a pharmacy information system can assist in inventory management, appropriate billing, and tracking of cost savings from pharmacist interventions.  Thus, this may be chosen as the first step for implementation.  While still costly, an incremental approach may ease the financial burden and allow for the costs to be realized over a longer period of time while maximizing on technologies that will most favorably impact efficiency and safety.  The budget should include pre-implementation costs for selecting a system and seeking funding, implementation costs including resource allocations for necessary software/hardware, data conversion, and for staff time, and post-implementation costs for maintenance and ongoing training. 

Resources:

• EHR Budget Worksheet (Excel - 139KB)  - Metastar

The guides provided below are tools to assist in broad planning and implementation processes.  They include instructions on applying for Federal designations and funding, budgeting and organizational planning.  Although not specific to health IT, these guides will be useful in planning and developing budgets for health IT implementations.

Additional Resources:

• So You Want to Start a Health Center?...A Practical Guide for Starting a Federally Qualified Health Center (PDF - 660KB) - NACHC 
• MALCHC Establishing a Community Health Center in Massachusetts (PDF - 290KB) 
• CMS Certification & Compliance - Critical Access Hospitals