EHR Stimulus Calculators and Lost Productivity

In my post about an EHR stimulus calculator on EMR and HIPAA, a user left an interesting comment that I thought might start some discussion:

Does the calculator account for the 30% loss in productivity that is essentially universal when a group adopts EMR? Most highly productive groups would be better off rejecting the stimulus, especially given the available crop of clickorrhea that passes for an EMR.

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John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

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  • John,

    Here’s a calculator on my company’s website that calculates the value of lost productivity stemming from the extra work associated with onerous data entry in the exam room (point-and-click documentation / meeting meaningful use requirements). Move the slide bar at the top to adjust the time lost per exam.

    For those not familiar with the numbers that should be input, try these which are for an average high-volume specialist (orthopaedic surgeon, ophthalmologist, etc.).

    Exams / Week = 125
    Weeks Worked / Year = 47
    Annual Physician Revenue = $1,100,000
    Exam Room Hours / Week = 24

  • Like everything, there will be a learning curve, and some loss of productivity. Doctors should stop whining about this, and embrace the digital age, as there are far more gains than losses long-term related to EMR adoption. This is not going to go away, and since there is a mandate for all clinical providers to chart electronically, they should simply accept the short-term losses, and realize that ultimately this technology will only benefit them, and more importantly, benefit the patients and the quality of patient care, in the long-run. They can make up the slight decline in their revenue stream down the road.

  • Evan,
    I like that calculator. Thanks for sharing. Now we just need to merge all the calculators into one that takes care of all the factors. Sounds like something that could be developed and sold to the RECs no?

  • Chris,
    My comments about lost productivity when you first implement an EMR. No doubt that’s something that can be planned for and dealt with. The problem is that there are a whole bunch of EMR software vendors that kill your productivity when you first implement and then many doctors find that because the software is so unusable they never end up returning to the pre-EMR productivity.

    I’m totally with you that if you choose the right EMR, then the long term benefits will totally outweigh the initial productivity losses. However, if you choose the wrong EMR, you might have long term productivity problems. That’s the challenge that doctors need to seriously consider.

  • Chris, it’s not just productivity I’m “whining” about. After 13 years of training, I think I know better than our IT department what kind of support I need to make life and death decisions every minute. I have used 6 EMRs in 7 hospitals in 3 states and none of them have made the job safer or faster. While some errors are prevented, more are created, and downtime throws the whole system into chaos. Furthermore, digital charting in almost every instance removes providers from the narrative and the meaningful exchange that forms the basis of the doctor patient relationship. Don’t get me wrong–I love computers and I even program games in my spare time. But until the hardware and software helps us instead of hurts, this push to EMR is just forcing us to make more errors, and further erodes our only task: to connect with people and rule out life-threatening disease.

  • Brian,
    You might be someone who does know what you need. In fact, I think it’s shameful when an EMR company tries to develop an EMR without LOTS of input and help from a wide variety of doctors. However, I would say that most doctors don’t know what they want in an EMR system since they are so focused on medicine that they don’t understand the difference between good EMR software and bad EMR software. There are exceptions, but quite frankly most doctors don’t care about it much at all.

    Don’t confuse this with doctors not caring about their practice or not caring about the way they practice medicine. They certainly care about efficiency and quality of medicine (at least almost all of them) and they want an EMR to provide those things. However, most of them haven’t put in the time and effort, nor had the experience to make this choice very well.

    With that said, IT people haven’t helped the doctors much either. They’ve created products that don’t focus on the needs of doctors and haven’t spend enough time getting feedback from doctors so the doctors not only will want their EMR, but can’t live without it.

    At the end of the day, it takes a unique mix of doctors and IT people to make it work the way it should. Until that happens, I think we’re going to be hearing a lot of “whining” from all parties.

  • I don’t think we’ll ever see a system that just comes naturally. All systems will require a learning curve. Even if it’s a change in a paper procedure.

    However, you might want to get an EMR while the government is paying you to do it instead of trying to find reasons to put it off. Then you’ll be paying in lost productivity AND penalties.

    But please have vendors demo their wares in person before you purchase! Even if some of them are out of your budget, it’s better to make an informed decision about what pieces you may be giving up with a less expensive system.

  • Jason D,
    I agree with you for the most part. Maybe I should have said, “more naturally” since there’s no doubt that not all EMR software is created equal. Some are just plain easier to use than others.

  • Hi all,
    Either I dont know how to use the calculator or Should I ask. How does this fit in wIth the recent changes (75% Medicare Allowable…) and is this calculator still valid?


  • Question: is the 30% productivity reduction a generally accepted estimate and for what time period – the first year of EMR adoption? For the time being, I’m excluding the factor of meaningful use documentation requirements. Thanks.

  • I’d say that the productivity reduction is EMR specific. I’d hope that the productivity reduction wasn’t the first year. The first week solves a lot of issues. By the first month most people are in a good rhythm. Then tweaks keep improving things forever.

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