Imminent adopters of electronic health records in ambulatory care.
BACKGROUND
Although evidence suggests electronic health records (EHRs) can improve quality and efficiency, provider adoption rates in the US ambulatory setting are relatively low. Prior studies have identified factors correlated with EHR use, but less is known about characteristics of physicians on the verge of adoption.


OBJECTIVE
To compare characteristics of physicians who are imminent adopters of EHRs with EHR users and non-users.


METHODS
A survey was mailed (June - November 2005) to a stratified random sample of all medical practices in Massachusetts. One physician from each practice (n=1884) was randomly selected to participate. Overall, 1345 physicians (71.4%) responded to the survey, with 1082 eligible for analysis due to exclusion criteria. 'Imminent adopters' were those planning to adopt EHRs within 12 months.


METHODS
We assessed physician and practice characteristics, availability of technology, barriers to adoption or expansion of health information technology (HIT), computer proficiency, and financial considerations.


RESULTS
Compared to non-users, imminent adopters were younger, more experienced with technology, and more often in practices engaged in quality improvement. More imminent adopters owned or partly owned their practices (57.4%) than users (33.5%; p<0.001), but fewer imminent adopters owned their practices than non-users (65.7%; p<0.001). Additionally, more imminent adopters (26.0%) reported personal financial incentives for HIT use than users (14.8%; p<0.001) and non-users (10.8%; p<0.001).


CONCLUSIONS
Imminent adopters of EHRs differed from users and non-users. Financial considerations appear to play a major role in adoption decisions. Knowledge of these differences may assist policy-makers and healthcare leaders as they work to increase EHR adoption rates.
Kaushal
Rainu
R
Department of Pediatrics, Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY, USA. rak2007@med.cornell.edu
Bates
David W
DW
Jenter
Chelsea A
CA
Mills
Shannon A
SA
Volk
Lynn A
LA
Burdick
Elisabeth
E
Tripathi
Micky
M
Simon
Steven R
SR
D000554:Ambulatory Care Facilities; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008404:Massachusetts; D016347:Medical Records Systems, Computerized; D008875:Middle Aged