Simon SR et al. 2007 "Physicians and electronic health records - a statewide survey."
Reference
Simon SR, Kaushal R, Cleary PD, et al. Physicians and electronic health records: a statewide survey. Arch Intern Med 2007;167(5):507-512.
Abstract
"Background: Electronic health records (EHRs) allow for a variety of functions, ranging from visit documentation to laboratory test ordering, but little is known about physicians' actual use of these functions. Methods: We surveyed a random sample of 1884 physicians in Massachusetts by mail and assessed availability and use of EHR functions, predictors of use, and the relationships between EHR use and physicians' perceptions of medical practice. Results: A total of 1345 physicians responded to the survey (71.4% response rate), and 387 (28.8%) reported that their practice had adopted EHRs. More than 80% of physicians
with EHRs reported having the ability to view laboratory reports (84.8%) and document visits electronically (84.0%), but considerably fewer reported being able to order laboratory tests electronically (46.8%) or transmit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision support, transmittal of electronic prescriptions, and radiology order entry actually used these functions most or all of the time. Compared with physicians who had not adopted EHRs, EHR users reported more positive views of the effects of computers on health care; there were no significant differences in these attitudes between high and low users of EHRs. Overall, about 1 in 4 physicians reported dissatisfaction with medical practice; there was no difference in this measure by EHR adoption or use. Conclusions: There is considerable variability in the functions available in EHRs and in the extent to which physicians use them. Future work should emphasize factors that affect the use of available functions."
with EHRs reported having the ability to view laboratory reports (84.8%) and document visits electronically (84.0%), but considerably fewer reported being able to order laboratory tests electronically (46.8%) or transmit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision support, transmittal of electronic prescriptions, and radiology order entry actually used these functions most or all of the time. Compared with physicians who had not adopted EHRs, EHR users reported more positive views of the effects of computers on health care; there were no significant differences in these attitudes between high and low users of EHRs. Overall, about 1 in 4 physicians reported dissatisfaction with medical practice; there was no difference in this measure by EHR adoption or use. Conclusions: There is considerable variability in the functions available in EHRs and in the extent to which physicians use them. Future work should emphasize factors that affect the use of available functions."
Objective
To address the barriers to electronic health records adoption, particularly with regards to how physicians use EHR systems. This includes the degree to which physicians use various "higher level" functions available in EHR systems as well as to identify factors that correlate with use and physician views on computers in health care.
Tools Used
Type Clinic
Primary care and specialty care
Size
Small and/or medium
Geography
Urban, suburban, and rural
Other Information
The number of clinics per practice ranged from one to greater than seven. The number of patients seen at each clinic per week ranged from 30 to 100.
Type of Health IT
Electronic health records (EHR)
Type of Health IT Functions
Functions studied included electronic prescription transmittal; laboratory order entry; alerts, warnings, and/or reminders; radiology order entry; clinical messaging; problem lists; medication lists; radiology test results; visit notes; and laboratory test results.
Context or other IT in place
Clinics were divided into those that had adopted EHR and those that had not. A total of 387 clinics had EHR in place at the time of the study and 794 did not. Of the respondents, 21.2 to 23.4 percent were receiving incentives for health IT adoption.
Workflow-Related Findings
Nonadopters were significantly more likely than EHR adopters to think that computers would have a significant effect on "patient-physician communication."
Nonadopters were significantly more likely than EHR adopters to think that computers would have a significant effect on "clinicians' access to up-to-date knowledge."
Nonadopters were significantly more likely than EHR adopters to think that computers would have a significant effect on the "efficiency of providing care."
Nonadopters were significantly more likely than EHR adopters to think that computers would have a significant effect on "interactions with the health care team."
Study Design
Other
Study Participants
Participants were actively practicing physicians in Massachusetts ambulatory practices in 2005.