EHRs may have an unintended side effect for smaller practices; namely, the disruption of existing communication patterns.
A 2013 study, called "The Impact of Electronic Health Record Use on Physician Productivity," by Harvard Business School professor Robert S. Huckman and University of Michigan assistant professor Julia Adler-Milstein, found that most primary-care and internal-medicine practices with four or more clinicians experienced higher productivity levels after providers began delegating EHR-related tasks to clinical support staff (registered nurses and medical assistants). Many smaller practices surveyed, however, reported a productivity loss.
Why? One hypothesis is that, in smaller groups, where informal, face-to-face communication is most effective, the introduction of an EHR might impose a more rigid process that can be counterproductive. "In larger practices where there may not be as much of the deep person-to-person communication on a regular basis, an IT system may be quite helpful in creating needed structure," says Huckman. "But smaller organizations often have existing patterns of interaction that are very rich, so the introduction of an IT system might make communication more formulaic and potentially not as effective in terms of care coordination."
That's not to dissuade practices from deploying an EHR, however. Huckman notes administrators and providers must simply recognize that person-to-person communication is an important asset to their practices and make efforts to keep those channels open even after EHR adoption.