J Am Med Inform Assoc - The long-term financial impact of electronic health record implementation.

Tópicos

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Resumo

JECTIVE: To examine the financial impact of electronic health record (EHR) implementation on ambulatory practices.METHODS: We tracked the practice productivity (ie, number of patient visits) and reimbursement of 30 ambulatory practices for 2 years after EHR implementation and compared each practice to their pre-EHR implementation baseline.RESULTS: Reimbursements significantly increased after EHR implementation even though practice productivity (ie, the number of patient visits) decreased over the 2-year observation period. We saw no evidence of upcoding or increased reimbursement rates to explain the increased revenues. Instead, they were associated with an increase in ancillary office procedures (eg, drawing blood, immunizations, wound care, ultrasounds).DISCUSSION: The bottom line result-that EHR implementation is associated with increased revenues-is reassuring and offers a basis for further EHR investment. While the productivity losses are consistent with field reports, they also reflect a type of efficiency-the practices are receiving more reimbursement for fewer seeing patients. For the practices still seeing fewer patients after 2 years, the solution likely involves advancing their EHR functionality to include analytics. Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients.CONCLUSIONS: Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context.

Resumo Limpo

jectiv examin financi impact electron health record ehr implement ambulatori practicesmethod track practic product ie number patient visit reimburs ambulatori practic year ehr implement compar practic preehr implement baselineresult reimburs signific increas ehr implement even though practic product ie number patient visit decreas year observ period saw evid upcod increas reimburs rate explain increas revenu instead associ increas ancillari offic procedur eg draw blood immun wound care ultrasoundsdiscuss bottom line resultthat ehr implement associ increas revenuesi reassur offer basi ehr invest product loss consist field report also reflect type efficiencyth practic receiv reimburs fewer see patient practic still see fewer patient year solut like involv advanc ehr function includ analyt although may still see fewer patient ehr analyt can focus see right patientsconclus practic reimburs increas ehr implement longterm decreas number patient visit seen ambulatori practic context

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