The impact of electronic medical record implementation on the outpatient volumes of a midsize academic center

Ann Plast Surg. 2014 Sep;73(3):330-2. doi: 10.1097/SAP.0000000000000314.


Background: Despite the proposed clinical advantages of electronic medical records (EMRs), many questions remain regarding how EMRs may limit the number of patients a provider can see on a day-to-day basis. In this study, we measured the impact of EMR implementation on outpatient volumes in the setting of a midsize academic medical center (AMC) in the southeast.

Methods: The AMC outpatient visit volumes of two 12-month periods, one before and one after the EMR implementation, were collected. The mean monthly outpatient visits before and after EMR implementation were compared using the 2-tailed Student t test without assumption for equal variance. We also normalized the total annual visits to the number of full-time equivalent physicians. Power calculation was performed to measure type II error whenever P value was greater than 0.05.

Results: There was an 8.37% increase in total outpatient visits after EMR implementation, with the monthly number of patients seen increasing from a mean (SD) of 25,763.75 (1673.96) to 27,919.92 (2229.07) (P = 0.018). However, this increase disappears when normalized to full-time equivalent. After conducting multiple subunit analyses of a multiphysician primary care clinic (Family Medicine), specialty clinic (Plastic Surgery), and single-physician specialty clinic (Pediatric Plastic Surgery), we also did not find a statistically significant difference in outpatient clinic volumes after EMR implementation.

Conclusions: Despite the burdensome time requirements many physicians subjectively attribute to EMRs, this study shows that the EMR has not really caused a statistically significant decrease in outpatient volumes in the setting of a midsize AMC.

Publication types

  • Evaluation Study

MeSH terms

  • Academic Medical Centers / statistics & numerical data*
  • Electronic Health Records*
  • Humans
  • Outpatients / statistics & numerical data*
  • Retrospective Studies