Evaluation of an electronic medical record system at an opioid agonist treatment program.

Abstract

The Addiction Research and Treatment Corporation evaluated the impact of an electronic medical record system. A prospective pre- and postimplementation design was utilized that examined the domains of quality, productivity, satisfaction, risk management, and financial performance. There were highly statistically significant improvements in timely completion of Annual Medical and 30-Day, 90-Day, and Annual Multidiscipline assessments. There was no statistically significant change in obtaining hepatitis C viral load for hepatitis C antibody-positive patients. The prevalence of risk management events was too low to detect statistically meaningful changes. Patient satisfaction was unchanged pre- and postimplementation, although staff satisfaction trended upward postimplementation. Productivity significantly declined for counseling staff; there was a nonsignificant productivity decline for medical services staff and a nonsignificant productivity increase for case manager staff. Revenue per capita staff increased by 0.6%, while cost per patient visit increased by 5.7%. Despite less robust results than expected, had we not implemented the electronic system, recent changes in documentation and reimbursement for services would have paralyzed our agency.