With government incentive and mandates driving the adoption of EHRs over the past couple years, the effects of these systems are starting to be observed, measured, and studied. Most outcomes of EHR adoption have been positive, but there have been a few drawbacks and obstacles in attempting to maximize their positive impact.

At the academic level, EHRs have added an increased layer of complexity to the teaching process at medical schools, a recent Oregon Health and Sciences University study suggests. The study, published in this month’s edition of Teaching and Learning in Medicine, focused on OHSU clinical teaching faculty that directly taught students while using their EHR system called Epic Care.

The research team surveyed the faculty in 2009 to determine how Epic Care, which was fully implemented by 2008, impacted their enthusiasm for teaching. The survey found that while over 70 percent of respondent were conformable using the system, a majority of the faculty agreed with the statement, “Epic Care distracts me from teaching students.” Less than one-third of the study’s respondents said the EHR offers advantages for teaching.

Another possible effect of EHR adoption on the healthcare industry could be its impact on hospital staffing. EHR systems often come with automated processes that could allow hospitals and providers to cut staff that currently performs these tasks manually.

A study from the University at Texas in Houston focused on how the number of EHR applications a hospital used impacted the amount of staff necessary to care for patients. The study’s findings published an article in the Journal of the Healthcare Financial Management Association said that for the most part hospitals in the study showed lower levels of efficiency per EHR application used. The authors theorized that the reason for this could be health records systems that are not fully paperless or not sufficiently customized to meet the needs of each particular hospital.

“(W)e found that only with clinical decision support, lab information, and quality/outcome management systems was… staffing below the average for all study hospitals by a statistically significant margin,” the article said.

Another case study in Arizona pointed to a provider that was able to save significantly through the automation of certain processes.  LaShonza Alexis, the billing supervisor at Drs. Goodwin & Partridge, OB/GYN, said her employer boosted bottom-line revenues by 26 percent.

In an article published in the February edition of Health Management Technology, Alexis described how 26-physician, seven-provider Drs. Goodwin & Partridge specialty practice was able to cut expenses by more than $1.5 million.

“Much of the cost savings the practice has realized can be traced to a reduction in paper costs and transcription fees, but it also comes from greater efficiencies at each practices offices,” she wrote.

“For example, multiple providers can work in the same chart at once, all offices share the same chart information and real-time billing is available for instant analysis.”

Alexis also mentioned that her practice was able to eliminate some of the labor needed when using a paper-based records system. Drs. Goodwin & Partridge used to employ four full-time in-house transcriptionists who were paid $31,000 annually and chart runners who were paid $20,000.