The impact of interoperability of electronic health records on ambulatory physician practices: a discrete-event simulation study. Academic Article uri icon

Overview

MeSH

  • Ambulatory Care Facilities
  • Humans
  • Monte Carlo Method
  • Qualitative Research

MeSH Major

  • Computer Simulation
  • Electronic Health Records
  • Practice Management, Medical
  • Systems Integration
  • Workflow

abstract

  • The effect of health information technology (HIT) on efficiency and workload among clinical and nonclinical staff has been debated, with conflicting evidence about whether electronic health records (EHRs) increase or decrease effort. None of this paper to date, however, examines the effect of interoperability quantitatively using discrete event simulation techniques. To estimate the impact of EHR systems with various levels of interoperability on day-to-day tasks and operations of ambulatory physician offices. Interviews and observations were used to collect workflow data from 12 adult primary and specialty practices. A discrete event simulation model was constructed to represent patient flows and clinical and administrative tasks of physicians and staff members. High levels of EHR interoperability were associated with reduced time spent by providers on four tasks: preparing lab reports, requesting lab orders, prescribing medications, and writing referrals. The implementation of an EHR was associated with less time spent by administrators but more time spent by physicians, compared with time spent at paper-based practices. In addition, the presence of EHRs and of interoperability did not significantly affect the time usage of registered nurses or the total visit time and waiting time of patients. This paper suggests that the impact of using HIT on clinical and nonclinical staff work efficiency varies, however, overall it appears to improve time efficiency more for administrators than for physicians and nurses.

publication date

  • 2013

has subject area

  • Ambulatory Care Facilities
  • Computer Simulation
  • Electronic Health Records
  • Humans
  • Monte Carlo Method
  • Practice Management, Medical
  • Qualitative Research
  • Systems Integration
  • Workflow

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.14236/jhi.v21i1.36

PubMed ID

  • 24629653

Additional Document Info

start page

  • 21

end page

  • 29

volume

  • 21

number

  • 1