Delivery System Reform & Breakthrough Opportunities, The Commonwealth Fund, New York, NY.
Health Serv Res. 2014 Feb;49(1 Pt 2):347-60. doi: 10.1111/1475-6773.12139. Epub 2013 Dec 21.
To describe trends in primary care physicians' use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality.
We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States.
We compared primary care physicians' HIT capacity in 2009 and 2012. We employed multivariable logistic regression to analyze whether participating in an integrated delivery system, sharing resources and support with other practices, and being eligible for financial incentives were associated with greater HIT capacity in 2012.
Primary care physicians' HIT capacity has significantly expanded since 2009, although solo practices continue to lag. Practices that are part of an integrated delivery system or share resources with other practices have higher rates of electronic medical record (EMR) adoption, multifunctional HIT, electronic information exchange, and electronic access for patients. Receiving or being eligible for financial incentives is associated with greater adoption of EMRs and information exchange.
Federal efforts to increase adoption have coincided with a rapid increase in HIT capacity. Delivery system and payment reforms and federally funded extension programs could offer promising pathways for further diffusion.
描述 2009 年至 2012 年间初级保健医生使用健康信息技术(HIT)的趋势,考察与 2012 年更高 HIT 能力相关的实践特征,并探讨可能影响采用和功能的交付系统和支付改革等因素。
我们使用了 2012 年和 2009 年联邦基金会国际初级保健医生卫生政策调查的数据。这两组数据均是在这两年的 3 月至 7 月间通过邮政邮件,在美国全国代表性的初级保健医生样本中收集的。
我们比较了初级保健医生在 2009 年和 2012 年的 HIT 能力。我们采用多变量逻辑回归分析了参与综合交付系统、与其他实践共享资源和支持以及有资格获得经济激励措施是否与 2012 年更高的 HIT 能力相关。
自 2009 年以来,初级保健医生的 HIT 能力显著扩大,尽管独资企业仍在落后。属于综合交付系统或与其他实践共享资源的实践,电子病历(EMR)的采用率、多功能 HIT、电子信息交换和患者电子访问的比率更高。接受或有资格获得经济激励措施与 EMR 和信息交换的更大采用率相关。
联邦政府增加采用的努力与 HIT 能力的快速增长相一致。交付系统和支付改革以及联邦资助的扩展计划可能为进一步扩散提供有希望的途径。