Comparison of Clinic Patient Wait-Time and Appointment Duration During Change in Electronic Health Record Systems

Saturday, April 18, 2015: 3:11 PM
Room 1A (San Diego Convention Center)
Elizabeth R. Richter, MD, PhD
Darren J. Guffey, BS
Rupal H. Trivedi, MD
Matthew J. Nutaitis, MD

The study goal was to examine clinic workflow changes when switching from one electronic health record (EHR) system to another (specifically, Medflow to Epic).

Retrospective chart review. Setting: Institutional Study population: Chart review of patients seen by Medical University of South Carolina ophthalmologists at baseline (2 weeks before transition to Epic or when using Medflow) and at early, intermediate, and late transition (2, 6 and 29 weeks after switching to Epic). Intervention or observation procedure: We recorded were demographics, subspecialty type, and appointment location. Data were processed in military time and subtraction was used to formulate values for initial wait-time and total appointment duration. We examined associations between wait-time and total appointment durations before and during the EHR switch using multivariable linear regression models. Main outcome measure: Changes in wait-time and total appointment duration.

We identified chart of 2,014 patients fitting inclusion criteria. When considering data from all clinics, mean wait-time was decreased 28% by late transition (P < 0.001) whereas total appointment duration increased 14% by early transition (P = 0.011). When considering data from the satellite clinics alone, wait-time decreased 50% at both intermediate and late transitions (P <0.001 and P <0.001, respectively), whereas total appointment duration increased 20% during early transition (P = 0.006).

To our knowledge this is the first study to examine the effect that switching from one EHR system to another has on patient wait-time and total appointment duration in an ophthalmology setting. Our findings could assist ophthalmologists in private, group or institutional practice considering such a switch, to prepare for expected workflow changes.