Study: Ophthalmologists Report Declining Productivity, Revenues Following EHR Adoption | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Study: Ophthalmologists Report Declining Productivity, Revenues Following EHR Adoption

January 2, 2018
by Rajiv Leventhal
| Reprints

Approximately 72 percent of U.S. ophthalmologists have adopted EHRs (electronic health records), but they are reporting that their net revenues and productivity have declined since implementing these systems, and that practice costs are higher with EHR use.

The findings of a recent study of 348 responding ophthalmologists by researchers at the Department of Ophthalmology and Vision Science, University of California, Davis, the Wilmer Eye Institute, Johns Hopkins University School, and elsewhere, were published in JAMA Ophthalmology. The research found that the EHR adoption rate among ophthalmologists has doubled since 2011—similar to the adoption rate of primary care physicians, which the study’s authors noted is around 79 percent— but in comparison with two previous EHR surveys, perceptions of practice costs and clinical productivity are more negative.

Back in 2006, a survey of U.S. ophthalmologists assessed adoption and perceptions of EHR systems, and found that the adoption rate of EHRs was low (19 percent), but was in line with that of other medical specialties in the U.S. at that time. That survey also found that the satisfaction rate of ophthalmologists already using an EHR at that time was high (69 percent satisfied or extremely satisfied). Then, in 2011, a follow-up survey was conducted that showed that the adoption rate of EHR had more than doubled to 47 percent among surveyed ophthalmologists. However, the satisfaction of ophthalmologists with their EHR and their perception of beneficial effects on practice productivity and costs had fallen in comparison with the 2006 data.

As such, the survey’s findings around ophthalmologists’ perceptions of their revenues and productivity levels in the last few years are perhaps most noteworthy. Respondents who were present during the conversion from paper records to EHR were asked questions about the perceived financial and clinical effect on their practice. They were also asked about productivity changes in terms of the number of patients seen per day. The data in the table below shows that a growing proportion of respondents perceive that productivity had decreased after EHR adoption when comparing results from the three different surveys.

Source: JAMA Ophthalmology

Meanwhile, perceptions of overall practice costs have changed since the 2006 survey, and the proportion of ophthalmologists who felt that costs were higher after the implementation of EHRs had increased (seen in figure below). The perception of net practice revenue after EHR was mixed; 35 percent thought it had stayed the same after EHR adoption and 41 percent thought it had decreased. Almost 9 percent felt that net revenue had increased, and 1.6 percent were unsure.

Source: JAMA Ophthalmology

The survey also found that of those ophthalmologists who attested for Stage 1 of the EHR incentive program (meaningful use), 83 percent had already or were planning to attest to Stage 2, but 9 percent had no plans to do so. One in five of responding ophthalmologists said they never had plans to attest to Stage 1 of the program.

Reasons for not attesting to Stage 1 were that their EHR was not certified (4 percent); the incentive was not relevant to their practice (23 percent); the cost of participating was too high (45 percent); and the complexity of participating was too high (38 percent). And reasons for not planning on Stage 2 attestation were the incentive was not relevant to their practice (5 percent); the cost of participating was too high (63 percent); and the complexity of participating was too high (68 percent).

The researchers concluded that the findings “suggest a need for improvement in two areas: usability of EHR and meaningful use requirements.” They added, “For example, more streamlined methods of viewing and interpreting diagnostic images and faster data entry for high-volume practices are necessary. Finally, while a significant proportion of respondents are engaged in federal EHR incentive programs, the cost and complexity of the programs are potential barriers to participation, and this emphasizes the need to simplify measures that are a part of the new Advancing Care Information [ACI] program that is the successor to meaningful use.”

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



Geisinger National Precision Health Hires Illumina Exec to Lead Business Development

Integrated health system Geisinger has hired a high-profile genetic counselor to head up business development for Geisinger National Precision Health, which was created to extend the Geisinger model on the national scene.

$30M VC Fund Launched to Spur Innovation in Cardiovascular Care

The American Heart Association, together with Philips and UPMC, has announced the launch of Cardeation Capital, a $30 million collaborative venture capital fund designed to spur healthcare innovation in heart disease and stroke care.

Epic Wins Labor Dispute in Closely Divided Supreme Court Decision

Epic Systems Corporation won a major labor-law ruling in the Supreme Court on Monday, centering around the extent of corporations’ right to force employees to sign arbitration agreements, and with a 5-4 ruling in its favor

Survey: Two-Thirds of Physician Practices Seeking Out Value-Based Care Consulting Firms

Most physician organizations are not prepared for the move to value-based care, and 95 percent CIOs of group practices and large clinics state they do not have the information technology or staff in-house needed to transform value-based care end-to-end, according to a recent Black Book Market Research.

Cumberland Consulting Buys LinkEHR, Provider of Epic Help Desk Services

Cumberland Consulting Group, a healthcare consulting and services firm, has acquired LinkEHR, which provides remote application support, including Epic help desk services.

Population Health Tool that Provides City-Level Data Expands to 500 Cities

A data visualization tool that helps city officials understand the health status of their population, called the City Health Dashboard, has now expanded to 500 of the largest cities in the U.S., enabling local leaders to identify and take action around the most pressing health needs in their cities and communities.