The Consequences of Electronic Health Record Adoption for Physician Productivity and Birth Outcomes
研究采用混合方法分析电子健康档案在门诊与医院间整合对医生生产率和分娩结局的影响，发现生产率下降11%但严重不良分娩事件减少37%。
The authors use a mixed-methods approach to investigate how the integration of electronic health records between ambulatory and hospital practices affected physician productivity and birth outcomes at a large health network. Physicians and staff were interviewed during a five-year staged integration of electronic health records, and a direct measure of physician productivity, relative value units, was analyzed concurrently with several measures of birth outcomes. The regression analyses show an 11% reduction in total productivity following the installation of the new system at primary-care sites. The qualitative findings indicate the reduction is attributable to the additional time physicians and staff needed to learn new processes, adopt work practice changes, and develop coordination. Nevertheless, users value the additional integration, especially as information flows back to the ambulatory practices from the hospital. This is supported by increases in treatment intensity over time and a 37% reduction in the severity of adverse birth events.