title: Barriers to EMR adoption in internal medicine and pediatric outpatient practices.
abstract: BACKGROUND
  Although electronic medical records (EMRs) are widely regarded as valuable tools in patient care, physicians in outpatient practices have been slow to adopt them. We sought to determine the current use of EMRs in area practices and identify physician attitudes related to their adoption.
  
  
  METHODS
  Fax and mail survey of randomly selected physician representatives of all outpatient practices of Internal Medicine (n=51) and Pediatrics (n=24) in Shelby County, Tenn. Scores on eight physician attitudes regarding barriers to EMR adoption were obtained using a Likert scale.
  
  
  RESULTS
  Survey response rate was 55%, with 18% reporting current EMR use. This corresponds to an EMR penetration of 20% for Shelby County. Current users were significantly less likely (P=0.005) than non-users to feel that an EMR interferes with doctor-patient interaction and less likely (P=0.019) to have EMR privacy concerns. While differences noted in other attitudes did not reach statistical significance, a trend was seen toward EMR users being less concerned (P=.0502) about reliability of an EMR. Large practices were no more likely than smaller ones to be using an EMR. Internal Medicine and Pediatric participants responded similarly to all items. The number of years in practice had no demonstrable impact on physician responses to these survey items.
  
  
  CONCLUSIONS
  In this West Tennessee physician population, EMR user and non-user attitudes markedly differed about impact on doctor-patient interaction and patient privacy. If such concerns could be addressed to the satisfaction of physicians considering EMRs in their practice, adoption rates might be increased.
authors.affiliation: Division of General Internal Medicine, University of Tennessee Health Science Center, Memphis 38105, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Russell
authors.forename: S Andrew
authors.initials: SA
authors.lastname: Spooner
mesh_terms: D000555:Ambulatory Care Information Systems; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003219:Confidentiality; D004059:Diffusion of Innovation; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000458:organization & administration* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D013714:Tennessee