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Journal of Ophthalmology
Volume 2015, Article ID 329819, 7 pages
Research Article

The Long-Term Financial and Clinical Impact of an Electronic Health Record on an Academic Ophthalmology Practice

1UC Davis Health System Eye Center, UC Davis School of Medicine, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
2Department of Statistics and Biostatistics, California State University, East Bay 25800 Carlos Bee Boulevard, Hayward, CA 94542, USA

Received 3 December 2014; Revised 11 February 2015; Accepted 13 February 2015

Academic Editor: Haoyu Chen

Copyright © 2015 Michele C. Lim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To examine financial and clinical work productivity outcomes associated with the use of the electronic health record (EHR). Methods. 191,360 billable clinical encounters were analyzed for 12 clinical providers over a 9-year study period during which an EHR was implemented. Main outcome measures were clinical revenues collected per provider and secondary outcomes were charge capture, patient visit coding levels, transcription costs, patient visit volume per provider, digital drawing, and digital imaging volume. Results. The difference in inflation adjusted net clinical revenue per provider per year did not change significantly in the period after EHR implementation (mean = $404,198; SD = $17,912) than before (mean = $411,420; SD = $39,366) (). Charge capture, the proportion of higher- and lower-level visit codes for new and established patients, and patient visits per provider remained stable. A total savings of $188,951 in transcription costs occurred over a 4-year time period post-EHR implementation. The rate of drawing the ophthalmic exam in the EHR was low (mean = 2.28%; SD = 0.05%) for all providers. Conclusions. This study did not show a clear financial gain after EHR implementation in an academic ophthalmology practice. Ophthalmologists do not rely on drawings to document the ophthalmic exam; instead, the ophthalmic exam becomes text-driven in a paperless world.