{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:06:24Z","timestamp":1773011184766,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T00:00:00Z","timestamp":1442880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims and objectives<\/jats:title><jats:p>The push for electronic medical record (<jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content>) implementation is grounded on increasing efficiency and cost savings. Our objective was to investigate the effect of <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> implementation on provider attrition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We completed a retrospective study investigating whether medical provider attrition, clinical <jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content> or equivalent, coincided with <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> implementation. We analysed monthly provider attrition rates and mean age at attrition 24 months preceding the <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> \u2018go\u2010live\u2019 date at our institution and 12 months after.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>208 provider departures occurred between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>uly 2011 and <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2014. The attrition categories were classified as \u2018departure\u2019 (<jats:italic>n<\/jats:italic>\u2009=\u2009137, 65.9%), \u2018emeritus\u2019 (<jats:italic>n<\/jats:italic>\u2009=\u200930; 14.4%), \u2018no specified reason\u2019 (<jats:italic>n<\/jats:italic>\u2009=\u200926; 12.5%) and \u2018not reappointed\u2019 (<jats:italic>n<\/jats:italic>\u2009=\u200915; 7.2). The most common degree held by departing providers was \u2018<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>\u2019 (<jats:italic>n<\/jats:italic>\u2009=\u2009170; 81.7%). Most departures occurred in <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2013 (<jats:italic>n<\/jats:italic>\u2009=\u200924). The mean provider age at departure was 46.4 years\u2009\u00b1\u20092.9 years for <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2012, 48.1 years\u2009\u00b1\u20092.5 years for <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2013 and 45.0 years\u2009\u00b1\u20094.1 years for <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2014. Our data indicate a trend for both an increase in number of departing providers, as well as an increased mean age in the month immediately prior to <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To date, no other investigation of the effect of <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> implementation of provider retirements have been published. We demonstrate a peak in provider attrition in the month prior to <jats:styled-content style=\"fixed-case\">EMR<\/jats:styled-content> implementation that may not be explained by normal attrition patterns with an academic calendar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level 5 \u2013 qualitative or descriptive study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12458","type":"journal-article","created":{"date-parts":[[2015,9,23]],"date-time":"2015-09-23T03:41:01Z","timestamp":1442979661000},"page":"222-226","source":"Crossref","is-referenced-by-count":12,"title":["Influence of electronic medical record implementation on provider retirement at a major academic medical centre"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9950-0985","authenticated-orcid":false,"given":"Matthew G.","family":"Crowson","sequence":"first","affiliation":[{"name":"Division of Otolaryngology \u2013 Head &amp; Neck Surgery Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Vail","sequence":"additional","affiliation":[{"name":"Department of General Surgery Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose J.","family":"Eapen","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head &amp; Neck Surgery Duke University Medical Center  Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,22]]},"reference":[{"issue":"171","key":"e_1_2_8_2_1","first-page":"52909","article-title":"Medicare and Medicaid programs; modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and other changes to EHR Incentive Program; and health information technology: revision to the certified EHR technology definition and EHR certification changes related to standards. Final rule","volume":"79","author":"Centers for M, Medicaid S, Office of the National Coordinator for Health Information Technology HHS","year":"2014","journal-title":"Federal Register"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000038"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocu049"},{"issue":"2","key":"e_1_2_8_5_1","first-page":"128","article-title":"Electronic medical records: the family practice resident perspective","volume":"33","author":"Aaronson J. 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