Custom EMRs Improve Efficiency

One-size-fits-all might work for Snuggies, but electronic medical records must be sized to fit the health care workers who use them.

That's the conclusion university researchers reached following a three-year study at six primary-care offices that implemented an EMR system. According to the University of California, Davis study, while some types of physicians became more efficient after an initial drop in productivity, others did not.

The difference was the amount of patient information and documentation doctors had to enter into the EMR, said Hemant Bhargava, associate dean at the UC Davis Graduate School of Management, in a news release.

Internal medicine specialists, who rely on test and lab results, patient history and notes from previous visits, increased their productivity after acclimating to a workplace with EMRs, Bhargava said. Electronic records can be reviewed more quickly and easily than paper records, saving internists time, he said.

But pediatricians and family-practice doctors tend to enter more information and documentation themselves, which takes more time, he said. Those physicians did not return to their pre-EMR level of productivity during the three-year study period.

The researchers concluded that electronic records should be tailored to the requirements and workflow demands of different kinds of medical professionals.

Physicians took about a month to get accustomed to using EMRs, the researchers said. During that time productivity dropped 25 percent to 33 percent.

"Initially, physicians and their staff had to learn the system," Bhargava said. "After a month of utilization, physicians and their staff became more comfortable with the technology and productivity overall increased to just below starting levels, with interesting variations by unit."

Data was gathered from 2003-2006 at a primary-care physician network affiliated with an academic medical center. The system digitized patient records and allowed for electronic prescriptions and messaging.

The researchers did not address whether advances in electronic record technology since that time might result in different conclusions today. The study was released late last week.