J Am Med Inform Assoc - Clinician characteristics and use of novel electronic health record functionality in primary care.

Tópicos

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Resumo

CKGROUND: Conventional wisdom holds that older, busier clinicians who see complex patients are less likely to adopt and use novel electronic health record (EHR) functionality.METHODS: To compare the characteristics of clinicians who did and did not use novel EHR functionality, we conducted a retrospective analysis of the intervention arm of a randomized trial of new EHR-based tobacco treatment functionality.RESULTS: The novel functionality was used by 103 of 207 (50%) clinicians. Staff physicians were more likely than trainees to use the functionality (64% vs 37%; p<0.001). Clinicians who graduated more than 10 years previously were more likely to use the functionality than those who graduated less than 10 years previously (64% vs 42%; p<0.01). Clinicians with higher patient volumes were more likely to use the functionality (lowest quartile of number of patient visits, 25%; 2nd quartile, 38%; 3rd quartile, 65%; highest quartile, 71%; p<0.001). Clinicians who saw patients with more documented problems were more likely to use the functionality (lowest tertile of documented patient problems, 38%; 2nd tertile, 58%; highest tertile, 54%; p=0.04). In multivariable modeling, independent predictors of use were the number of patient visits (OR 1.2 per 100 additional patients; 95% CI 1.1 to 1.4) and number of documented problems (OR 2.9 per average additional problem; 95% CI 1.4 to 6.1).CONCLUSIONS: Contrary to conventional wisdom, clinically busier physicians seeing patients with more documented problems were more likely to use novel EHR functionality.

Resumo Limpo

ckground convent wisdom hold older busier clinician see complex patient less like adopt use novel electron health record ehr functionalitymethod compar characterist clinician use novel ehr function conduct retrospect analysi intervent arm random trial new ehrbas tobacco treatment functionalityresult novel function use clinician staff physician like traine use function vs p clinician graduat year previous like use function graduat less year previous vs p clinician higher patient volum like use function lowest quartil number patient visit nd quartil rd quartil highest quartil p clinician saw patient document problem like use function lowest tertil document patient problem nd tertil highest tertil p multivari model independ predictor use number patient visit per addit patient ci number document problem per averag addit problem ci conclus contrari convent wisdom clinic busier physician see patient document problem like use novel ehr function

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