title: The effect of electronic health records adoption on patient visit volume at an academic ophthalmology department.
abstract: BACKGROUND
  Electronic health records (EHRs) have become a mandated part of delivering health care in the United States. The purpose of this study is to report patient volume before and after the transition to EHR in an academic outpatient ophthalmology practice.
  
  
  METHODS
  Review of patient visits per half-day and number of support staff for established faculty ophthalmologists between July and October for five consecutive years beginning the year before EHR implementation.
  
  
  RESULTS
  Eight physicians met inclusion criteria for the study. The number of patient visits was lower in each year after EHR adoption compared to baseline p ≤ 0.027). Patient volume per provider was reduced an average of 16.9% over the 4 years (range 15.3-18.5%), and during the final year studied, no provider had returned to the pre-EHR number of patients per clinic session. Support staffing was unchanged (p > 0.2).
  
  
  CONCLUSIONS
  Adoption of EHR was associated with a significantly reduced number of patient visits per clinic session in an academic setting in which support staffing remained stable. Maintaining clinic volume and access in similar settings may require use of additional staffing.
authors.affiliation: Department of Ophthalmology, University of Washington, 325 Ninth Ave, Box 359608, Seattle, WA, 98104, USA.
authors.forename: Jocelyn G
authors.initials: JG
authors.lastname: Lam
authors.affiliation: Department of Ophthalmology, University of Washington, 325 Ninth Ave, Box 359608, Seattle, WA, 98104, USA.
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, University of Washington, 325 Ninth Ave, Box 359608, Seattle, WA, 98104, USA. pchen@uw.edu.
authors.forename: Philip P
authors.initials: PP
authors.lastname: Chen
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000554:Ambulatory Care Facilities; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational / Q000592:standards; D057286:Electronic Health Records / Q000458:organization & administration*; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009885:Ophthalmology / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D058996:Quality Improvement; D014481:United States / Q000453:epidemiology