Health Services and Policy Analysis Program, University of California, Berkeley, California 94720, USA.
J Am Med Inform Assoc. 2013 Jun;20(e1):e26-32. doi: 10.1136/amiajnl-2012-001271. Epub 2013 Feb 8.
We sought to determine the extent to which adoption of health information technology (HIT) by physician practices may differ from the extent of use by individual physicians, and to examine factors associated with adoption and use.
Using cross-sectional survey data from the National Study of Small and Medium-Sized Physician Practices (July 2007-March 2009), we examined the extent to which organizational capabilities and external incentives were associated with the adoption of five key HIT functionalities by physician practices and with use of those functionalities by individual physicians.
The rate of physician practices adopting any of the five HIT functionalities was 34.1%. When practices adopted HIT functionalities, on average, about one in seven physicians did not use those functionalities. One physician in five did not use prompts and reminders following adoption by their practice. After controlling for other factors, both adoption of HIT by practices and use of HIT by individual physicians were higher in primary care practices and larger practices. Practices reporting an emphasis on patient-centered management were not more likely than others to adopt, but their physicians were more likely to use HIT.
Larger practices were most likely to have adopted HIT, but other factors, including specialty mix and self-reported patient-centered management, had a stronger influence on the use of HIT once adopted.
Adoption of HIT by practices does not mean that physicians will use the HIT.
我们旨在确定医生实践中采用健康信息技术（HIT）的程度与个别医生使用程度之间的差异，并研究与采用和使用相关的因素。
使用来自全国中小规模医师实践研究（2007 年 7 月至 2009 年 3 月）的横断面调查数据，我们考察了组织能力和外部激励因素与医生实践中采用五种关键 HIT 功能以及个体医生使用这些功能之间的关联程度。
采用五种 HIT 功能中的任何一种的医生实践比例为 34.1%。当实践采用 HIT 功能时，平均每七个医生中就有一个不使用这些功能。在实践采用提示和提醒后，每五个医生中就有一个不使用这些功能。在控制其他因素后，实践采用 HIT 和个体医生使用 HIT 的比例在初级保健实践和较大的实践中更高。报告强调以患者为中心的管理的实践并不比其他实践更有可能采用，但他们的医生更有可能使用 HIT。
较大的实践最有可能采用 HIT，但其他因素，包括专业混合和自我报告的以患者为中心的管理，在采用 HIT 后对其使用有更强的影响。
实践采用 HIT 并不意味着医生会使用 HIT。
