AJM onlineClinical research studyPerceptions of Electronic Health Record Implementation: A Statewide Survey of Physicians in Rhode Island
Section snippets
Study Design
This study has a cross-sectional survey design.
Study Setting and Population
The Rhode Island Department of Health administered the Health Information Technology Survey electronically over the course of 3 weeks in January and February of 2009 to 2013.7 The department used its licensure database to send letters and e-mails (when available) to all licensed physicians providing direct patient care. Participants who did not complete the survey were excluded from these analyses.
Study Measurements
Survey questions included provider and practice
Results
The survey response rate was 62% in 2013, with 2365 of 3799 physicians completing surveys. Most doctors work more than 20 hours per week, have Doctor of Medicine degrees, have their primary practice in an office, are primary care providers, and work in groups of more than 10 providers (Table 1). There are differences between respondents with and without an electronic health record. Respondents with an electronic health record are likely to have larger populations of patients with Medicaid
Discussion
We present the most comprehensive assessment of statewide physician electronic health record use to date, documenting how electronic health record adoption has increased among all licensed providers in Rhode Island from 2009 to 2013.9, 10 By using 2013 data, we identified physician and practice traits associated with electronic health record adoption, including younger age, more patients with Medicaid insurance, hospital practice, practice in larger groups, and primary care practice. We also
Conclusions
We estimate that 81% of Rhode Island physicians are now using an electronic health record of some description. Surgical subspecialists and psychiatrists are less likely to use an electronic health record, so adoption in the remaining providers may be improved by better tailoring to these providers. We also find that although most providers find their job satisfaction decreases with electronic health record introduction, there is evidence that longer duration of use and improvement in electronic
Acknowledgments
The annual Health Information Technology Survey is funded by the State of Rhode Island's Healthcare Quality Reporting Program. The survey is jointly administered by the Rhode Island Department of Health and its public reporting contractor, Healthcentric Advisors, whose work is appreciated. This article was written as part of the Quality Improvement class at the School of Public Health at Brown University. The authors acknowledge the invaluable input of the class and instructor Dr Amal Trivedi,
References (23)
- et al.
The impact of electronic medical record systems on outpatient workflows: a longitudinal evaluation of its workflow effects
Int J Med Inform
(2010) Wiring the health system–origins and provisions of a new federal program
N Engl J Med
(2011)- et al.
Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus
Ann Intern Med
(2012) - et al.
Implementation of an outpatient electronic health record and emergency department visits, hospitalizations, and office visits among patients with diabetes
JAMA
(2013) - et al.
Effect of electronic health records on health care costs: longitudinal comparative evidence from community practices
Ann Intern Med
(2013) - et al.
Assessing the impact of electronic health records as an enabler of hospital quality and patient satisfaction
Acad Med
(2013) - et al.
Associations between structural capabilities of primary care practices and performance on selected quality measures
Acad Med
(2009) - et al.
Creating a survey to assess physicians' adoption of health information technology
Med Care Res Rev
(2012) Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys
(2011)- et al.
The Adoption and Use of Health Information Technology (HIT) by Rhode Island Physicians, 2009
Med Health R I
(2010)
Rhode Island Physicians' Health Information Technology (HIT) Use, 2009-2011
Med Health R I
Cited by (0)
Funding: MCW work is supported by an educational stipend from the University Emergency Medical Foundation.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.