J Am Med Inform Assoc - Use of electronic medical records differs by specialty and office settings.

Tópicos

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Resumo

JECTIVE: To assess differences in the use of electronic medical records (EMRs) among medical specialties and practice settings.METHODS: A cross-sectional retrospective study using nationally representative data from the National Ambulatory Medical Care Survey for the period 2003-2010 was performed. Bivariate and multivariate analyzes compared EMR use among physicians of 14 specialties and assessed variation by practice setting. Differences in EMR use by geographic region, patient characteristics, and physician office settings were also assessed.RESULTS: Bivariate and multivariate analysis demonstrated increased EMR use from 2003 to 2010, with 16% reporting at least partial use in 2003, rising to 52% in 2010 (p<0.001). Cardiologists, orthopedic surgeons, urologists, and family/general practitioners had higher frequencies of EMR use whereas psychiatrists, ophthalmologists, and dermatologists had the lowest EMR use. Employed physicians had higher EMR uptake than physicians who owned their practice (48% vs 31%, p<0.001). EMR uptake was lower among solo practitioners (23%) than non-solo practitioners (42%, p<0.001). Practices owned by Health Maintenance Organizations had higher frequencies of EMR use (83%) than practices owned by physicians, community health centers, or academic centers (all <45%, p<0.001). Patient demographics did not affect EMR use (p>0.05).CONCLUSIONS: Uptake of EMR is increasing, although it is significantly slower in dermatology, ophthalmology, and psychiatry. Solo practitioners and owners of a practice have low frequencies of EMR use compared with non-solo practitioners and those who do not own their practice. Despite incentives for EMR adoption, physicians should carefully weigh which, if any, EMR to adopt in their practices.

Resumo Limpo

jectiv assess differ use electron medic record emr among medic specialti practic settingsmethod crosssect retrospect studi use nation repres data nation ambulatori medic care survey period perform bivari multivari analyz compar emr use among physician specialti assess variat practic set differ emr use geograph region patient characterist physician offic set also assessedresult bivari multivari analysi demonstr increas emr use report least partial use rise p cardiologist orthoped surgeon urologist familygener practition higher frequenc emr use wherea psychiatrist ophthalmologist dermatologist lowest emr use employ physician higher emr uptak physician own practic vs p emr uptak lower among solo practition nonsolo practition p practic own health mainten organ higher frequenc emr use practic own physician communiti health center academ center p patient demograph affect emr use pconclus uptak emr increas although signific slower dermatolog ophthalmolog psychiatri solo practition owner practic low frequenc emr use compar nonsolo practition practic despit incent emr adopt physician care weigh emr adopt practic

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