Efficiency of automation and electronic health records in optometric practice

Health information technology (HIT) consists of technological advancements in health care instrumentation, integration, and documentation. It is now beginning to reach a level of consistency, and its benefits are being realized in clinical practice. Comparisons between paper and digital documentation have been conducted in various specialties. There have also been studies comparing manual and automated documentation. Our study was designed to compare the overall benefit of an electronic health record (EHR) and clinical automation accompanied with HIT advancements to traditional modes of practice within the Optometry Clinic at Walter Reed Army Medical Center.

All processes and procedures used in the study were equivalent to those used in patient visits common to most optometric practices. They included patient check-in, pretesting by an ophthalmic technician, and a comprehensive eye examination by an optometrist. In addition to the quantitative time measurements for these procedures, the frequency of certain events was recorded to ascertain the value of automation versus conventional methods of patient management, testing, treatment, and documentation.

Although no process time showed any statistically significant difference, some trends were evident. There was a trend toward increased efficiency in the automated group during "Doctor Examination" and "Total Time" subsections. Also, there was a trend toward decreased efficiency with the automated group during the "Check-In" section.

Automation and EHR technology will likely improve over time and surpass the medical efficiency of conventional modes of care. It is impressive that the early stage of HIT used in this study showed no detraction from clinical efficiency while potentially offering many patient, provider, and administrative benefits.