title: The business end of health information technology. Can a fully integrated electronic health record increase provider productivity in a large community practice?
abstract: Electronic health records (EHRs) are expected to transform and improve the way medicine is practiced. However, providers perceive many barriers toward implementing new health information technology. Specifically, they are most concerned about the potentially negative impact on their practice finances and productivity. This study compares the productivity of 75 providers at a large urban primary care practice from January 2005 to February 2009, before and after implementing an EHR system, using longitudinal mixed model analyses. While decreases in productivity were observed at the time the EHR system was implemented, most providers quickly recovered, showing increases in productivity per month shortly after EHR implementation. Overall, providers had significant productivity increases of 1.7% per month per provider from pre- to post-EHR adoption. The majority of the productivity gains occurred after the practice instituted a pay-for-performance program, enabled by the data capture of the EHRs. Coupled with pay-for-performance, EHRs can spur rapid gains in provider productivity.
authors.affiliation: New York City Department of Health and Mental Hygiene, 161 William Street, 5th Floor, CN-52, New York, NY 10038, USA. sdeleon@health.nyc.gov
authors.forename: Samantha
authors.initials: S
authors.lastname: De Leon
authors.forename: Alison
authors.initials: A
authors.lastname: Connelly-Flores
authors.forename: Farzad
authors.initials: F
authors.lastname: Mostashari
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Shih
mesh_terms: D003153:Community Health Services; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D014481:United States