How to Examine Post-Launch EHR Productivity

Article excerpt

Once you implement your electronic health record, study key metrics to ensure best practices


* The best way to assess the effect of an EHR is to look at its impact on productivity, overhead, and general quality of life.

* The EHR will deliver a better bottom line, but not without a strong, ongoing effort at integrating the technology tool into the clinical operations.

Before you implement an electronic health record (EHR) system, it's important to analyze and document your practice's procedures. To get the most out of your system once it is in place, you'll want to examine your staff's performance and analyze key metrics. The insights you gain will help you ensure that practice productivity continues to increase and stabilize.

Here, Robert Rowley, MD, Shahid Shah, and Rosemarie Nelson- three healthcare industry experts in the areas of health information technology implementation, EHR development for primary care, and practice management- share their knowledge in easy-to-follow steps that you can apply immediately to ensure the health and longevity of your practice post-EHR implementation.

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Predicting the EHR pay-off

By Robert Rowley, MD, Health information technology consultant

An electronic health record (EHR) system, which replaces the use of paper charts in your medical practice, affects everything that touches a patient's chart. In other words, it affects just about everything.

How can you tell whether it is worth it? How can you measure the effect on productivity, overhead, and general quality of life brought about by EHR adoption? By having some useful measurement tools.

The best way to assess the effect of an EHR is to look at three domains:

* the effect on productivity,

* the effect on overhead, and

* the effect on quality of life.

For the purposes of this discussion, we will include the effect on quality of care under the heading of productivity.


In a practice that relies on fee-for-service income as the mainstay of its compensation, the effect of an EHR on productivity can be measured in several ways:

* Raw volume. For ambulatory practices, look at an average of how many visits per day occurred before EHR implementation (use a 1 -month survey to calculate average visits per day). Then count the average visits per day 30 days after implementation, 3 months after implementation, 6 months after implementation, and 1 year after implementation. Doing so should provide a sense of dip in productivity (which is common and can last weeks to months).

* Intensify of service. Look at the total receipts deposited for a 1 -month interval (or total billings, although actual deposits probably are a better measure) and divide by the total number of visits for that month. The result is the average dollars received per visit Compare this number before and after EHR implementation (30 days, 3 months, 6 months, and 1 year).

If part of your compensation comes from achieving clinical quality measure (COM) goals (some practices, especially primary care practices, can have as much as 25% of their income come from performance-based compensation), then the measures can be either simple, or more sophisticated:

* Look at the performance-based income (perhaps weighted by total patient volume, in case that varies) in global gross dollars before and at intervals after EHR adoption.

* If the EHR Is able to measure specific CQM achievement (or if there are other COM measurement tools outside the EHR), then use those reports to see whether quality measures are improving, deteriorating, or remaining flat after EHR implementation compared with before implementation. …