Post date: Apr 22, 2016 5:32:03 AM
Hemant K. Bhargava and Abhay Mishra
This paper (PDF, SSRN) studies impact of EMR technologies on physician productivity. EMR technologies are unique in the sense that they are operated by the highest-paid employees in the organization (physicians) rather than lower-level and lower-paid employees. Hence, concerns about impact of EMR on physician productivity are paramount. We studied EMR rollout at a University hospital, with pre-EMR and post-EMR productivity data for about 100 physicians, representing three primary care specialities (pediatrics, internal medicine, and family practice) across 10 clinics. We found a typical and recurring dynamics, with about a 25% fall in productivity after EMR adoption, followed by a 3-5 month recovery phase during which productivity levels returned near pre-EMR levels. Importantly, we found evidence of a specialty-effect in post-EMR long-term productivity: the long-term impact varies based on the nature of information work that different types of physicians perform (information review vs. information entry). Today's EMR technologies have great productivity-improving features for information review, but inefficient controls for information entry. Consequently, pediatricians and family practice doctors suffered a small drop in long-term productivity (they see repeat patients and have less value for information review; and they have more documentation needs), while internal medicine doctors (who see patients they often don’t know, and after other providers have already entered patient data) enjoyed a slight bump in productivity. The key conclusion for industry is that while systems may need to be standardized around data structures, they ought to be differentiated at the user interface level; a one-size-fits-all interface is not ideal. Both the findings and design implications have created a lot of buzz in industry.