June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Implementation of electronic health record systems in ophthalmology: impact on clinical volume compared to other medical fields
Author Affiliations & Notes
  • Travis Redd
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Sarah Read-Brown
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Anne Kitzmiller
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Thomas Yackel
    Ophthalmology & Medical Informatics, Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Dongseok Choi
    Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR
  • Michael Chiang
    Ophthalmology & Medical Informatics, Casey Eye Institute, Oregon Health & Science University, Portland, OR
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4426. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Travis Redd, Sarah Read-Brown, Anne Kitzmiller, Thomas Yackel, Dongseok Choi, Michael Chiang; Implementation of electronic health record systems in ophthalmology: impact on clinical volume compared to other medical fields. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4426.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

Electronic health records (EHRs) have the potential to improve efficiency and quality of ophthalmic care. However, concerns have been raised about a possible negative impact on patient volume in ophthalmology due to unique documentation requirements, high clinical volume, and relatively limited attention from vendors. This study aims to compare the impact of EHR implementation on patient volume in ophthalmology to 7 other specialty and primary care fields (orthopedics, dermatology, hematologic malignancies, hematology/oncology, cardiology, family medicine, and pediatrics).

 
Methods
 

An institution-wide EHR system (Epic; Madison, WI) was implemented at Oregon Health & Science University from 2006-2008. Stable clinical providers were identified from among the 8 departments listed above, and quarterly patient volume recorded for each via query of the EHR system. Data for each department was collected from 9 months before to 36 months after EHR implementation. Provider characteristics were recorded, including gender, age, department, and patient volume. Descriptive statistics and paired t-tests were used to evaluate the data.

 
Results
 

86 stable providers were identified, including 23 from ophthalmology and 4-12 from each of the other departments. Ophthalmology showed a small non-significant decrease in volume (Table 1) following implementation (range: 93-97% of baseline, p 0.52-0.81). The 5 other specialties combined experienced an increase in volume (surgical group range: 107-124%; medical group range: 110-121%). This change was significant only for dermatology (p 0.03), hematology/oncology (p 0.04-0.27), and cardiology (p 0.01-0.02). Primary care departments trended toward decreased volume (range: 88-90%, p 0.18-0.28). Provider characteristics associated with increased volume included low pre-implementation clinical volume (p 0.04-0.12), female gender (p 0.21-0.57), and younger age (p 0.12-0.60, Table 1).

 
Conclusions
 

At this medical center, EHR implementation did not have a significant negative impact on clinical volume in ophthalmology. In comparison, other specialty fields had significantly increased volume, while primary care fields trended toward decreased volume. This suggests that EHR may not have a negative impact on volume in ophthalmology or other specialty fields, but further research is needed to determine the generalizability of these findings.

  
Keywords: 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×