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Kara Marie Cavuoto, Pedro Monsalve, Joyce C Schiffman, Ta Chen Chang; Trends in Patient Satisfaction During Transition to Electronic Medical Records in the Pediatric Ophthalmology Clinic. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1377.
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© ARVO (1962-2015); The Authors (2016-present)
The use of electronic medical records (EMR) has been federally mandated since early 2014. We evaluated the impact of the shift to EMR on patient satisfaction in a tertiary care center pediatric ophthalmology practice.
Prospective, cross-sectional survey completed at three time points: two weeks prior to (phase 1), two weeks after (phase 2), and three months after (phase 3) transition to EMR. A questionnaire consisting of ten Likert-type scaled questions assessing satisfaction with two free response questions estimating wait time was completed by a parent (or guardian) whose child (<18 years) was scheduled for a pediatric ophthalmology visit. Satisfaction scores and wait times were compared within each phase and across phases, as well as between appointment types (new, follow up, preoperative, and postoperative).
A total of 321 surveys were collected: 137 from phase 1, 55 from phase 2 and 129 from phase 3. The survey response rate was 91%, 84% and 94% for phase 1, 2 and 3 respectively. Of the total visits, 63% were followups, 23% were new, 5% were preoperative and 7% were postoperative. Overall patient satisfaction seemed to be high in all phases without a statistically significant difference between phases or types of appointment. Parent estimates of wait time were longer in phase 1 than phase 2 (p=0.03), however not statistically significant at other points. The wait time to see the physician decreased from phase 1 to phase 2 (129 to 105 min), but increased at phase 3 (139 min), so that phases 1 and 3 were similar (p=0.3). The wait time and the time spent with the physician were longest for new visits (156 and 50 min then followup (128 and 20 min), preoperative (93 and 17 min) and postoperative (73 and 19 min) (p=<0.05). The estimated time spent with the physician was longer in phase 2 than phase 1 (p=0.0015) and in phase 3 than phase 1 (p=<0.001), however the actual amount of time spent with the physician was similar (26 vs 30 vs 24 min) and not statistically significant (p=0.74).
The transition to EMR did not impact parent satisfaction. In fact, parents perceived that the physician spent longer with them after EMR implementation. The decrease in wait time in phase 2 is likely due to an intentional reduction in clinical volume in anticipation of the EMR learning curve with return to pre-EMR levels as clinical volumes resumed normal levels.
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