Implementing an electronic medical record at a residency site: physicians' perceived effects on quality of care, documentation, and productivity.
BACKGROUND
Electronic Medical Records (EMRs) are quickly becoming a standard component of medical practices.


OBJECTIVE
We longitudinally studied the impact of EMR implementation on physician perceptions of quality of care, documentation, and work hours, as well as on measured physician productivity.


METHODS
Physicians were surveyed at 3-month intervals regarding perceived impact of the EMR on quality of care, documentation, and productivity. Relative Value Units (RVUs) per clinic hours were used to measure productivity. Paired t-tests were used to compare the mean RVUs per clinic hour in the pre-EMR with the immediate post-EMR time period and the long-term post-EMR time period.


RESULTS
RVUs per hour increased significantly from the pre-EMR time period to the immediate post-EMR time period (means 1.49 and 1.82, respectively, P = 0.0007). The long-term post-EMR time period also showed a significant increase over the pre-EMR period (mean 1.79, P = 0.007). Sixty-six percent of physicians perceived that EMR implementation increased their work amount a little or much more.


CONCLUSIONS
Not only did physician production rise immediately, it stayed at the increased level for the duration of our study period. This may be due to improved documentation supporting more appropriate billing. However, physicians also perceived the EMR as taking up more of their time.
Brotzman
Gregory L
GL
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, USA. brotzman@mcw.edu
Guse
Clare E
CE
Fay
David L
DL
Schellhase
Kenneth G
KG
Marbella
Anne M
AM
D001291:Attitude of Health Personnel; D003197:Computer Literacy; D004282:Documentation; D004526:Efficiency; D006801:Humans; D007396:Internship and Residency; D008137:Longitudinal Studies; D016347:Medical Records Systems, Computerized; D015999:Multivariate Analysis; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014922:Wisconsin; D016526:Workload