Appl Clin Inform - Physician specialty and variations in adoption of electronic health records.

Tópicos

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Resumo

JECTIVE: Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored.METHODS: We conducted a retrospective cross-sectional study to determine the association between physician specialty and the prevalence of EHR adoption, and a retrospective serial cross-sectional study to determine the association of physician specialty and the rate of EHR adoption over time. We used the 2005-2009 National Ambulatory Medical Care Survey. We considered fourteen specialties, and four definitions of EHR adoption (any EHR, basic EHR, full EHR, and a novel definition of EHR sophistication). We used multivariable logistic regression, and adjusted for several covariates (geography, practice characteristics, revenue characteristics, physician degree).RESULTS: Physician specialty was significantly associated with EHR adoption, regardless of the EHR definition, after adjusting for covariates. Psychiatrists, dermatologists, pediatricians, ophthalmologists, and general surgeons were significantly less likely to adopt EHRs, compared to the reference group of family medicine/general practitioners. After adjustment for covariates, these specialties were 44-94% less likely to adopt EHRs than the reference group. EHR adoption increased in all specialties, by approximately 40% per year. The rate of EHR adoption over time did not significantly vary by specialty.CONCLUSIONS: Although EHR adoption is increasing in all specialties, adoption varies widely by specialty. In order to insure each individual's network of providers can electronically share data, widespread adoption of EHRs is needed across all specialties.

Resumo Limpo

jectiv effort promot adopt electron health record ehr focus primari care physician now expect exchang data electron provid includ specialist howev variat ehr adopt among specialist underexploredmethod conduct retrospect crosssect studi determin associ physician specialti preval ehr adopt retrospect serial crosssect studi determin associ physician specialti rate ehr adopt time use nation ambulatori medic care survey consid fourteen specialti four definit ehr adopt ehr basic ehr full ehr novel definit ehr sophist use multivari logist regress adjust sever covari geographi practic characterist revenu characterist physician degreeresult physician specialti signific associ ehr adopt regardless ehr definit adjust covari psychiatrist dermatologist pediatrician ophthalmologist general surgeon signific less like adopt ehr compar refer group famili medicinegener practition adjust covari specialti less like adopt ehr refer group ehr adopt increas specialti approxim per year rate ehr adopt time signific vari specialtyconclus although ehr adopt increas specialti adopt vari wide specialti order insur individu network provid can electron share data widespread adopt ehr need across specialti

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