The study was conducted from 2003 to 2006 following the rollout of an EHR system across six care sites of a large primary-care network affiliated with an academic medical center.
“Our research suggests that a ‘one-size-fits-all' design does not work—the ideal technology design should vary by physicians' requirements and work-flow demands,” Bhargava said in a news release.
The researchers found that the initial implementation of the EHR system resulted in a 25% to 33% drop in physician productivity compared against data collected on work hours and output before the introduction of EHR technology—not an unexpected outcome.
In the following months, however, while productivity improved, researchers found that internal medicine units “adjusted to the new technology and experienced a slight increase in productivity,” according to a UC Davis news release about the report. “In contrast, pediatricians and family practice doctors did not return to their original productivity levels and experienced a slightly lower productivity rate.”
EHRs increase a provider's efficiency for information review—patient history, notes from previous visits, charts of test data and radiological images—features of higher value to internists “who tend to see a greater proportion of ill patients,” according to the statement. “In contrast, pediatricians' work tends to involve more information entry and documentation for which EHR technology can be more time-consuming,” it said.
"These differences by unit suggest that there is a mismatch between technology design and the work-flow requirements and health administration expectations for individual care units," Bhargava said in the statement.