Do Years of Experience with Electronic Health Records Matter for Productivity in CHCs?

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Journal Article

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electronic health records; community health centers; productivity; workforce


OBJECTIVE Community health centers’ (CHCs) patient panels are expected to increase in the coming years. This study investigated to what the years of experience with an electronic health record (EHR) was related to the productivity of CHCs. DATA/SETTING We primarily drew from the 2012 Uniform Data System, an annual reporting system of 1198 CHCs receiving federal Section 330 grants. We also used the “Readiness Survey” to categorize CHCs by years of experience with an EHR. DESIGN/METHODS We estimated a log-linear model of average annual medical visits, weighted for service intensity, as a function of full-time equivalent medical staff controlling for CHC size and location. We compared the productivity of each type of medical staff by presence of an EHR, EHR vendor, and years of EHR experience. RESULTS Physician productivity significantly improved in CHCs with three to four years of EHR experience. Nurses experienced a notable negative productivity impact in the early years of EHR adoption, although the trend was not statistically significant. CONCLUSIONS Attention should be paid as to whether nurses are diverted away from clinical duties to manage administrative tasks related to EHRs, and whether staffing levels are sufficient to support the implementation of EHRs. CHCs may need additional support and training especially for nurses in order to maintain the CHCs’ current patient panel, and even more so if the patient population expands as Medicaid coverage expands under the Affordable Care Act.


This work is funded through HRSA Cooperative Agreement U81HP26493: Health Workforce Research Centers Program.

Article published in: Frogner B, Wu X, Ku L, Pittman P, Masselink L. 2017. Do Years of Experience With Electronic Health Records Matter for Productivity in Community Health Centers? Journal of Ambulatory Care Management, 40(1): 36–47. doi: 10.1097/JAC.0000000000000171

Open Access


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