title: Electronic health record impact on productivity and efficiency in an academic pediatric ophthalmology practice.
abstract: OBJECTIVE
  To measure the effect of electronic health record (EHR) implementation on productivity and efficiency in the pediatric ophthalmology division at an academic medical center.
  
  
  METHODS
  Four established providers were selected from the pediatric ophthalmology division at the Oregon Health & Science University Casey Eye Institute. Clinical volume was compared before and after EHR implementation for each provider. Time elapsed from chart open to completion (OTC time) and the proportion of charts completed during business hours were monitored for 3 years following implementation.
  
  
  RESULTS
  Overall there was an 11% decrease in clinical volume following EHR implementation, which was not statistically significant (P = 0.18). The mean OTC time ranged from 5.5 to 28.3 hours among providers in this study, and trends over time were variable among the four providers. Forty-four percent of all charts were closed outside normal business hours (30% on weekdays, 14% on weekends).
  
  
  CONCLUSIONS
  EHR implementation was associated with a negative impact on productivity and efficiency in our pediatric ophthalmology division.
authors.affiliation: Department of Ophthalmology, Portland, Oregon; Department of Public Health & Preventive Medicine, Portland, Oregon.
authors.forename: Travis K
authors.initials: TK
authors.lastname: Redd
authors.affiliation: Department of Ophthalmology, Portland, Oregon.
authors.forename: Sarah
authors.initials: S
authors.lastname: Read-Brown
authors.affiliation: Department of Ophthalmology, Portland, Oregon; Department of Public Health & Preventive Medicine, Portland, Oregon; Community Dentistry, Oregon Health & Science University, Portland, Oregon.
authors.forename: Dongseok
authors.initials: D
authors.lastname: Choi
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Portland, Oregon.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Yackel
authors.affiliation: Department of Ophthalmology, Portland, Oregon; Operative Care Division, Portland Veterans Affairs Medical Center, Portland, Oregon.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Tu
authors.affiliation: Department of Ophthalmology, Portland, Oregon; Department of Medical Informatics & Clinical Epidemiology, Portland, Oregon. Electronic address: chiangm@ohsu.edu.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Chiang
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D002648:Child; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D014481:United States