If electronic medical records are so great, why aren't family physicians using them?
OBJECTIVE
The chasm theory of marketing states that fundamental differences exist between early adopters of technology and the mainstream marketplace, making it difficult for technology to transition to the mainstream market. We investigated possible differences in attitudes and beliefs about electronic medical records (EMRs) between current EMR users (early market) and nonusers (mainstream market).


METHODS
Cross-sectional mail survey.


METHODS
Active members in the Indiana Academy of Family Physicians 2000-2001 membership database (N = 1328).


METHODS
Differences in attitudes, beliefs, and demographic characteristics of EMR users and nonusers.


RESULTS
The overall return rate was 51.7%; 14.4% of respondents currently use an EMR. Electronic medical record users were more likely to practice in urban areas or to be hospital-based and reported seeing fewer patients. Nonusers were less likely to believe that (1) physicians should computerize their medical records; (2) current EMRs are a useful tool for physicians; (3) EMRs improve quality of medical records and decrease errors; and (4) it is easy to enter data into current EMRs. Nonusers were more likely to believe that paper records are more secure and more confidential than EMRs. Both users and nonusers believed that current EMRs are too expensive.


CONCLUSIONS
A chasm exists between EMR users and nonusers regarding issues that affect EMR implementation, including necessity, usefulness, data entry, cost, security and confidentiality. To reach full implementation of EMRs in family medicine, organizations should use these data to target their research, education, and marketing efforts.
Loomis
Glenn A
GA
St. Francis Family Practice Residency Program, Beech Grove, IN 46107, USA. gloomis@iquest.net
Ries
J Scott
JS
Saywell
Robert M
RM
Thakker
Nitesh R
NR
D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003430:Cross-Sectional Studies; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D006801:Humans; D007196:Indiana; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data