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The long-term financial impact of electronic health record implementation
Journal article   Open access

The long-term financial impact of electronic health record implementation

Michael J. Howley, Edgar Y. Chou, Nancy Hansen and Prudence W. Dalrymple
Journal of the American Medical Informatics Association : JAMIA, v 22(2), pp 443-452
01 Mar 2015
PMID: 25164255
url
https://doi.org/10.1136/amiajnl-2014-002686View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Computer Science Computer Science, Information Systems Computer Science, Interdisciplinary Applications Health Care Sciences & Services Information Science & Library Science Life Sciences & Biomedicine Medical Informatics Science & Technology Technology
Objective To examine the financial impact of electronic health record (EHR) implementation on ambulatory practices. Methods We tracked the practice productivity (ie, number of patient visits) and reimbursement of 30 ambulatory practices for 2 years after EHR implementation and compared each practice to their pre-EHR implementation baseline. Results Reimbursements significantly increased after EHR implementation even though practice productivity (ie, the number of patient visits) decreased over the 2-year observation period. We saw no evidence of upcoding or increased reimbursement rates to explain the increased revenues. Instead, they were associated with an increase in ancillary office procedures (eg, drawing blood, immunizations, wound care, ultrasounds). Discussion The bottom line result-that EHR implementation is associated with increased revenues-is reassuring and offers a basis for further EHR investment. While the productivity losses are consistent with field reports, they also reflect a type of efficiency-the practices are receiving more reimbursement for fewer seeing patients. For the practices still seeing fewer patients after 2 years, the solution likely involves advancing their EHR functionality to include analytics. Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients. Conclusions Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context.

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37 citations in Scopus

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Web of Science research areas
Computer Science, Information Systems
Computer Science, Interdisciplinary Applications
Health Care Sciences & Services
Information Science & Library Science
Medical Informatics
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