OBJECTIVES: To estimate the return on investment (ROI) associated with database integration technology enabling automated bidirectional sharing of patient data between a hospice and hospice pharmacy provider. METHODS: ROI was calculated as total direct savings (TDS) and payback period in years (PPY). Formula inputs were costs of implementing a bidirectional interface between the pharmacy and hospice, and costs of telephone/fax transmission of demographic and medication data. The net present value (NPV) adjusted for inflation was used to forecast future cash inflows across three years. RESULTS: Estimated annual savings for unidirectional interface were $7500 and bidirectional savings were $22,500 for a hospice admitting 300 patients/month, assuming $50,000 nurse salary. Hospice nurses were assumed to use wireless phones for transmission of patient admission data. Replacement of voice with interface resulted in estimated savings of $1800 annually. Telephone savings for medication profile data transmission yielded $1620 annually. After summing the immediate gains of recovered time inefficiencies and reduced telephone usage, implementation of a pharmacy/hospice interface resulted in TDS of $33,420 annually. The discounted or investment yield rate utilized was 10%. Therefore, while projected total net savings generated by a pharmacy/hospice interface across 3 years equaled $100,260, the total NPV, reflecting the time value of money, was $84,596. The annual ROI represented by the NPV of the pharmacy/hospice interface was 1127.94%. The PPY (breakeven analysis) in which the financial benefits exceed the initial investment would be reached in 0.27 years. CONCLUSIONS: ”Low-tech” bias and lack of capital for investment in technology have contributed to a lag in adoption of technological innovations in hospice. Projected ROI for automated data sharing via interface suggested considerable decrease in administrative costs. Hospice administrators could apply the formulas used in this study with their unique data to forecast ROI in their settings.