Table 3 Studies reporting on efficiency and productivity pre- and post-EPR implementation
StudyYearMain findings
Yadav et al.772017More documentation errors overall
Improved physical finding documentation
Akenroye et al.1172017No effect on hypertension or obesity rates
Haidar et al.882017Reduced physician productivity in outpatients
Riahi et al.1002017Overall significant cost savings due to reduced medication errors, better implementation of clinical practice guidelines, improved infection prevention and cost-effective diagnostic testing.
McDowell et al.892017Operating theatres increase in patient turnaround time of around 20% post-implementation, which returned to baseline by 6 months
Caryon et al.1072017Reduced ITU medication errors
Rupp et al.862017Emergency department, sustained increase in length of patient stay until around 1 year later.
Dean et al.962016Improved quality of discharge summaries
Han et al.932016Reduced severe medication errors and ICU mortality
Finn et al.1062016Improved detection of prescribing errors
Raval et al.1052015Reduced clerical errors, work hours saved annually by EPR-based handovers.
Wormer et al.762015Significant increase (approximate doubling) in average time spent by junior staff documenting in the first 6 months post-EPR implementation, which improves over time but remains greater than baseline
Singh et al.872015No effect on efficiency
Flatow et al.922015Reduced ICU mortality
Ward et al.822014Transient increased length of stay until 8 weeks
Increased laboratory testing and imaging
Ward et al.832014No effect on emergency room length of stay
Reddy et al.842014No effect on outpatient volume
Patterson et al.852014No effect on readmission rates (cardiac)
Hye et al.1162014Increase in aortic aneurysm screening rates
Gascon et al.1042013Laboratory medicine, reduced errors, improved turnaround times, integration into record
McGuire et al.1132013Improved ability to provide care more safely.
Wang et al.1142013Increased appropriate antithrombotic therapy, blood pressure control, HbA1c testing and smoking cessation intervention.
Reed et al.1152013Reduced emergency visits in patients with diabetes mellitus
Gascon et al.1042013Improved laboratory processes (better patient identification, less labelling or requesting errors and shorter response times)
Kritz et al.1082012Improved annual assessment performance
Spellman et al.812012Transient increased emergency department length of stay and time to see doctor, resolved by 3 months
Herrin et al.1122012Patients with diabetes more likely to receive optimal care
Cook et al.1032011Increased antimicrobial recommendations
Reduced antibiomtic use
Reduced nosocomial infections.
Albuquerque et al.952011Reduced physician calls to treatment units
Harshberger et al.1092011Improved quality of data collection
Gunnigberg et al.110,1112008, 2009Post-EPR improvement in recording of pressure ulcers.
Verwey et al.792008No time efficiency savings
Grieger et al.972007Improved billing accuracy and cost recovery
Rosenbloom et al.942006Improved documentation of weight and height (growth charts)
Evans et al.9820065% productivity increases per annum
Pizziferri et al.782005No difference in overall time per patient in clinic
Keshavgee et al.752001Increased clinician time required for documentation
Returns to baseline by 18 months post-go-live