Kaushal Rainu, Bates David W, Jenter Chelsea A, Mills Shannon A, Volk Lynn A, Burdick Elisabeth, Tripathi Micky, Simon Steven R
Department of Pediatrics, Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY, USA.
Inform Prim Care. 2009;17(1):7-15. doi: 10.14236/jhi.v17i1.709.
Although evidence suggests electronic health records (EHRs) can improve quality and efficiency, provider adoption rates in the US ambulatory setting are relatively low. Prior studies have identified factors correlated with EHR use, but less is known about characteristics of physicians on the verge of adoption.
To compare characteristics of physicians who are imminent adopters of EHRs with EHR users and non-users.
A survey was mailed (June - November 2005) to a stratified random sample of all medical practices in Massachusetts. One physician from each practice (n=1884) was randomly selected to participate. Overall, 1345 physicians (71.4%) responded to the survey, with 1082 eligible for analysis due to exclusion criteria. 'Imminent adopters' were those planning to adopt EHRs within 12 months.
We assessed physician and practice characteristics, availability of technology, barriers to adoption or expansion of health information technology (HIT), computer proficiency, and financial considerations.
Compared to non-users, imminent adopters were younger, more experienced with technology, and more often in practices engaged in quality improvement. More imminent adopters owned or partly owned their practices (57.4%) than users (33.5%; p<0.001), but fewer imminent adopters owned their practices than non-users (65.7%; p<0.001). Additionally, more imminent adopters (26.0%) reported personal financial incentives for HIT use than users (14.8%; p<0.001) and non-users (10.8%; p<0.001).
Imminent adopters of EHRs differed from users and non-users. Financial considerations appear to play a major role in adoption decisions. Knowledge of these differences may assist policy-makers and healthcare leaders as they work to increase EHR adoption rates.
尽管有证据表明电子健康记录（EHR）可提高质量和效率，但美国门诊环境中医疗服务提供者的采用率相对较低。先前的研究已确定了与EHR使用相关的因素，但对于即将采用EHR的医生的特征了解较少。
比较即将采用EHR的医生与EHR使用者和非使用者的特征。
2005年6月至11月，向马萨诸塞州所有医疗执业机构的分层随机样本邮寄了一份调查问卷。从每个执业机构随机选择一名医生（n = 1884）参与调查。总体而言，1345名医生（71.4%）回复了调查问卷，由于排除标准，1082名医生符合分析条件。“即将采用者”是指计划在12个月内采用EHR的医生。
我们评估了医生和执业机构的特征、技术可用性、健康信息技术（HIT）采用或扩展的障碍、计算机熟练程度以及财务考虑因素。
与非使用者相比，即将采用者更年轻，对技术更有经验，并且更常参与质量改进的执业机构。与使用者（33.5%；p<0.001）相比，更多即将采用者拥有或部分拥有自己的执业机构（57.4%），但与非使用者（65.7%；p<0.001）相比，拥有自己执业机构的即将采用者较少。此外，与使用者（14.8%；p<0.001）和非使用者（10.8%；p<0.001）相比，更多即将采用者（26.0%）报告有使用HIT的个人财务激励。
EHR的即将采用者与使用者和非使用者不同。财务考虑因素似乎在采用决策中起主要作用。了解这些差异可能有助于政策制定者和医疗保健领导者努力提高EHR采用率。
