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Vinod B. Voleti, Alexandra L. Braunstein, Cristina Mahabir, Amilia Schrier, Michael F. Chiang; Evaluation Of An Academic Eye Clinic’S Practice Efficiency During The Early Transition Period To An Electronic Health Record System. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5549.
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In 2008, a national survey found that only 12% of ophthalmologists were using electronic health record (EHR) systems. More recently, major federal government initiatives have promoted nationwide adoption and use of EHRs. However, this has raised concerns about potential loss of practice efficiency, particularly during the initial implementation period. The purpose of this study is to report the change in patient volume and visit cycle times during the initial EHR implementation period for an eye clinic at an academic medical center.
After several years of planning, the Columbia University/New York Presbyterian Hospital eye clinic underwent transition to EHR in late July 2010. Patient visit numbers were decreased by 50%, and gradually increased over a three-week transition period. Monthly patient visit numbers were compared before vs. after EHR implementation using electronic registration logs. Baseline patient visit cycle times (i.e. time for each stage of patient visit from registration to time when finished with MD) were recorded by staff, residents, and an outside evaluator for a one-week period, both prior to and after EHR implementation.
During the first three months after EHR implementation, the mean (range) patient volume was 1508.7 (1513-1655) visits per month. This was 6% lower than the mean (range) patient volume during the same three-month period of the previous year (1682.3 [1621-1719] visits per month), but this difference was not statistically significant (p = 0.31). The mean visit cycle time was 147 +/- 70 minutes (n=198 patients) after EHR implementation, which was not statistically different (p=0.92) from the mean visit cycle time before implementation (148 +/- 130 minutes, n=266 patients).
There were no significant changes in patient volume or patient visit cycle times during the early EHR implementation period at our academic eye clinic. Long-term studies of practice quality, efficiency, and patient satisfaction will provide additional information about the clinical impact of ophthalmology EHR systems.
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