Due Diligence in EHR Selection, can it help you Preserve Physician Productivity?

There are many commentaries, and anecdotal examples, of what happens to EHR Meaningful Use criteria will outweigh the incentive payments that are available.

So maybe it’s time to take a look at the published research on physician productivity in organizations that have implemented an EHR system.  It is important to take note of how little actual research there is in this area, but also important to note that at least some of the studies out there confirm that productivity can and does increase after implementation of an EHR system.

To wit:

  • A 2010 study of 203 physicians in a multi-specialty group implementing the EPIC system showed a statistically significant increase of 9 provider visits per month in the group of physicians that adopted the system, vs. non-adopters.  [International Journal of Medical Informatics, on-line first (05/15/2010), Cheriff, Adam D., et al.]
  • A 2004 time-and-motion study of 20 primary care physicians at Partners Healthcare System showed a decrease in time spent per patient of 0.5 minutes (p= 0.86, 95% confidence interval) post-implementation.  Interestingly, only 29% of participants reported that documenting in the EHR takes the same or less time than a paper-based system.  [Journal of Biomedical Informatics, 38 (2005), 176-188, Lisa Pizziferri, et al.]

Many other practices report that while physician productivity initially “takes a hit”, it returns to pre-implementation levels within a few weeks or months after implementation.  And practices that have had a successful implementation say they would never go back to paper.

In an effort to help make the transition a bit more smooth …

Three things to help minimize the disruption of workflow and physician productivity during EHR implementation …

  1. Make a good initial selection.  Make sure the system you select is the best overall EHR for your practice.  “EHR Due Diligence” is the watchword here, not the “Ready, Fire, Aim” approach that some vendors will try to walk you through.
  2. Don’t skimp on training.  An EHR system, especially for an office of first-time users, is a tremendous change, and intensive training is required.  Imagine trading in the auto you use to drive to work for an airplane (or even worse, a helicopter!) that you will use for your commute.  Even though they are both modes of transportation, you would never think of simply getting in the airplane, even after a few hours of training, and flying yourself to work.
  3. Practice, practice, practice!  Formal training is a must, but so is practice after training.  Training introduces you to the tool, but practice starts you on the road to proficiency.  It also allows you to take advantage of the customization available with most systems, developing shortcuts and templates that are unique to your practice, and that will speed up your use of the system when you go live.

There are many strategies to try during the go-live period to minimize the impact on productivity, including lighter schedules, phased implementation, etc.  Whatever you do, keep in mind that implementing an EHR system is one of the biggest changes most medical practices will face.  EHR is a transformative technology, that will affect your medical practice and the entire healthcare system in the future.  There is simply no substitute for getting it right the first time.

To learn more about an EHR due diligence approach, sign up for a free EHR technology system reference guide from The Fox Group.  This complete 26 page booklet is a logical and sequential description of the process: The Art and Science of Evaluating, Selecting, and Implementing an Electronic Health Records System.

When you need proven expertise and performance

Jim Hook, MPH

Mr. James D. Hook has over 30 years of healthcare executive management and consulting experience in medical groups, hospitals, IPA’s, MSO’s, and other healthcare organizations.

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