Multiple EMR types needed by primary-care physicians

Adding electronic medical records to hospitals and clinics with the idea of a "one-size-fits-all" design does not work, researchers at the University of California at Davis report.

Instead, the ideal technology design "should vary by physicians' requirements and work-flow demands," said one of the researchers, Hemant Bhargava, associate dean and professor of management and computer science at the school's graduate school of management.

Bhargava and his colleagues completed their study of a multimillion‑dollar information technology project installed at six primary-care offices from 2003 to 2006. The system studied had digitized patient records and allowed for electronic prescriptions and messaging.

The data was collected for about 100 physicians spread across three primary care categories--internal medicine, pediatrics and family practice--among six clinics. The researchers found that the initial implementation of the EMR system resulted in a 25 to 33 percent drop in physician productivity. While significant, the drop was anticipated, Bhargava said.

Over the next few months, the researchers found that the impact of the new technology on productivity varied by physician group: Internal medicine units adjusted to the new technology and experienced a slight increase in productivity. In contrast, pediatricians' work tended to involve more information entry and documentation for which EMR technology was more time-consuming.

"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 a statement.

For more details:
- here's the UC Davis news release
- read the CMIO article

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