Editorial Comments: Comments on Return on Investment (ROI) As It Applies to Clinical Systems

In the current issue of this journal, Kaushal and colleagues present an exemplary, thorough analysis of the financial impact of installing computerized physician order entry (CPOE) in a major academic hospital. This excellent work quantifies quantifiable parameters clearly, estimates other parameters conservatively, and lists problems associated with measurement of the remaining small set of other factors. This work is arguably the best that can be done with respect to evaluating CPOE return on investment (ROI). Why does it not quite seem to be enough or to be sufficient to persuade?