The Adoption Gap in Physician Office Practice
A November 2006 issue brief by Joy M. Grossman and Marie C. Reed of the Center for Studying Health System Change is entitled "Clinician Information Technology Gaps Persist Among Physicians."
The study is based on a nationally representative telephone survey of physicians involved in direct patient care drawn from the AMA and AOA master files. All candidates were active, non-federal, office- and hospital-based practitioners who spent at least 20 hours a week in direct patient care (residents and fellows were excluded). 12,000 physicians responded in 2001 and 6,600 responded in 2005 (52% response rate).
Among the questions, physicians were asked "in your practice, are computer or other forms of information technology used:
Small groups (3-9 physicians) claim 43 % use clinical data exchange, 40% access notes, 25% generate reminders, and 12% write prescriptions. Lower numbers for accessing notes and exchange data are found in 1-2 physician practices with approximately 30% claiming to use computers to exchange data and to access patient notes.
These data seem to suggest that the use of a portal to a hospital is considered data exchange by the respondents.
All data demonstrate a significant difference in availability of functions as a result of physician practice size.
Interestingly, the authors claim that high Medicaid providers (> %25 of total practice revenue) were as likely or more likely than others to report HIT use for each of the clinical activities both in the current survey and in the 2001 survey. Although data are not presented, the authors claim this access is not a function of practice size and that the of high Medicaid providers in solo (37%) or two physician (21%) practices were as likely to use HIT as their peers.
The study is based on a nationally representative telephone survey of physicians involved in direct patient care drawn from the AMA and AOA master files. All candidates were active, non-federal, office- and hospital-based practitioners who spent at least 20 hours a week in direct patient care (residents and fellows were excluded). 12,000 physicians responded in 2001 and 6,600 responded in 2005 (52% response rate).
Among the questions, physicians were asked "in your practice, are computer or other forms of information technology used:
- to obtain information about treatment alternative or recommended guidelines
- for clinical data and image exchange with other physicians
- to access patient notes, medication lists, or problems
- to generate reminders for you about preventive services, and
- to write prescriptions"
They were not asked if they themselves used computers, nor were they asked specific details such as the use of an EMR, practice-management system, or Web-based portal. So the data for use are an upper bound for physician practice and subject to the limitation of all surveys of this type.
Overall, use of computers in clinical practice settings is growing. Most interesting is the claim that 50% exchanging clinical data, 50% are accessing clinical notes, 30% are using reminders, and 22% are using e-prescribing.Small groups (3-9 physicians) claim 43 % use clinical data exchange, 40% access notes, 25% generate reminders, and 12% write prescriptions. Lower numbers for accessing notes and exchange data are found in 1-2 physician practices with approximately 30% claiming to use computers to exchange data and to access patient notes.
These data seem to suggest that the use of a portal to a hospital is considered data exchange by the respondents.
All data demonstrate a significant difference in availability of functions as a result of physician practice size.
Interestingly, the authors claim that high Medicaid providers (> %25 of total practice revenue) were as likely or more likely than others to report HIT use for each of the clinical activities both in the current survey and in the 2001 survey. Although data are not presented, the authors claim this access is not a function of practice size and that the of high Medicaid providers in solo (37%) or two physician (21%) practices were as likely to use HIT as their peers.
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