Patel Vaishali, Swain Matthew J, King Jennifer, Furukawa Michael F
Senior Advisor, Office of Economic Analysis Evaluation and Modeling Office of the National Coordinator for Health Information Technology, 200 Independence Ave SW, Washington, DC 20201. E-mail:
Am J Manag Care. 2013 Oct;19(10):835-43.
To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement.
Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care.
The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics.
In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries.
In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.
利用2011年国家门诊医疗护理调查电子病历补充资料，提供全国范围内医生与其他医疗服务提供者进行临床信息电子共享能力的估计数据，并描述各州及电子健康记录（EHR）供应商之间在信息交换能力方面的差异。
对提供直接患者护理的非联邦门诊医生进行全国代表性抽样调查。
通过邮寄问卷并进行电话随访开展调查，加权回复率为61%。总体样本包括4326名受访者。我们计算了国家和州层面的电子交换能力估计值，并应用多变量分析来检验不同类型临床信息交换能力与医生及医疗实践特征之间的关联。
2011年，55%的医生具备以电子方式发送处方的计算机化能力；67%的医生能够以电子方式查看实验室检查结果；42%的医生能够将实验室检查结果纳入其电子健康记录；35%的医生能够以电子方式发送实验室检查医嘱；31%的医生与其他医疗服务提供者交换患者临床总结。信息交换能力的最强预测因素是采用电子健康记录。然而，在地理区域和电子健康记录供应商之间，信息交换能力存在很大差异，尤其是临床总结的电子交换。
2011年，大多数门诊医生能够交换实验室检查和用药数据，约三分之一的医生能够与患者或其他医疗服务提供者交换临床总结。电子健康记录是医生交换临床数据的关键机制，不过医生的交换能力因供应商和州而异。
