Study: Physician EMR productivity varies by group
The introduction of EMRs in hospitals and clinics appears to have varying effects on different types of primary care physicians, according to a study from the University of California, Davis.
"Our research suggests that a 'one-size-fits-all' design does not work—the ideal technology design should vary by physicians' requirements and workflow demands," said Hemant Bhargava, associate dean and professor of management and computer science at the UC Davis Graduate School of Management.
Bhargava and colleagues completed a study of an IT project installed at six primary care offices from 2003 to 2006. The offices were part of a large primary care physician network affiliated with an academic medical center. The system digitized patient records and allowed for e-prescribing and messaging.
For the study, researchers analyzed the impact the technology had on physician productivity, collecting data on work hours and output before and after the introduction of EMR technology. The data were collected for about 100 physicians spread across three primary care categories—internal medicine, pediatrics and family practice—and six clinics.
The researchers found that the initial implementation of the EMR system resulted in a 25 percent to 33 percent drop in physician productivity.
Over the next few months, the researchers found that the impact of the new technology on productivity varied by physician group. Internal medicine units adjusted to the new technology and experienced a slight increase in productivity.
In contrast, pediatricians and family practice doctors did not return to their original productivity levels and experienced a slightly lower productivity rate.
"Initially, physicians and their staff had to learn the system," Bhargava explained. "After a month of utilization, physicians and their staff became more comfortable with the technology and productivity overall increased to just below starting levels, with interesting variations by unit.
"These differences by unit suggest that there is a mismatch between technology design and the workflow requirements and health administration expectations for individual care units.”
According to the authors, the use of EMRs makes information review—patient history, notes from previous visits, charts of test data and radiological images—more efficient. In contrast, pediatricians' work tends to involve more information entry and documentation for which EMR technology can be more time-consuming.
Bhargava suggested vendors and medical centers consider implementing different versions of electronic record keeping systems, tailoring the user interface, information entry and visualization features for different groups of physicians.
"Our research suggests that a 'one-size-fits-all' design does not work—the ideal technology design should vary by physicians' requirements and workflow demands," said Hemant Bhargava, associate dean and professor of management and computer science at the UC Davis Graduate School of Management.
Bhargava and colleagues completed a study of an IT project installed at six primary care offices from 2003 to 2006. The offices were part of a large primary care physician network affiliated with an academic medical center. The system digitized patient records and allowed for e-prescribing and messaging.
For the study, researchers analyzed the impact the technology had on physician productivity, collecting data on work hours and output before and after the introduction of EMR technology. The data were collected for about 100 physicians spread across three primary care categories—internal medicine, pediatrics and family practice—and six clinics.
The researchers found that the initial implementation of the EMR system resulted in a 25 percent to 33 percent drop in physician productivity.
Over the next few months, the researchers found that the impact of the new technology on productivity varied by physician group. Internal medicine units adjusted to the new technology and experienced a slight increase in productivity.
In contrast, pediatricians and family practice doctors did not return to their original productivity levels and experienced a slightly lower productivity rate.
"Initially, physicians and their staff had to learn the system," Bhargava explained. "After a month of utilization, physicians and their staff became more comfortable with the technology and productivity overall increased to just below starting levels, with interesting variations by unit.
"These differences by unit suggest that there is a mismatch between technology design and the workflow requirements and health administration expectations for individual care units.”
According to the authors, the use of EMRs makes information review—patient history, notes from previous visits, charts of test data and radiological images—more efficient. In contrast, pediatricians' work tends to involve more information entry and documentation for which EMR technology can be more time-consuming.
Bhargava suggested vendors and medical centers consider implementing different versions of electronic record keeping systems, tailoring the user interface, information entry and visualization features for different groups of physicians.