title: When does adoption of health information technology by physician practices lead to use by physicians within the practice?
abstract: OBJECTIVE
  We sought to determine the extent to which adoption of health information technology (HIT) by physician practices may differ from the extent of use by individual physicians, and to examine factors associated with adoption and use.
  
  
  METHODS
  Using cross-sectional survey data from the National Study of Small and Medium-Sized Physician Practices (July 2007-March 2009), we examined the extent to which organizational capabilities and external incentives were associated with the adoption of five key HIT functionalities by physician practices and with use of those functionalities by individual physicians.
  
  
  RESULTS
  The rate of physician practices adopting any of the five HIT functionalities was 34.1%. When practices adopted HIT functionalities, on average, about one in seven physicians did not use those functionalities. One physician in five did not use prompts and reminders following adoption by their practice. After controlling for other factors, both adoption of HIT by practices and use of HIT by individual physicians were higher in primary care practices and larger practices. Practices reporting an emphasis on patient-centered management were not more likely than others to adopt, but their physicians were more likely to use HIT.
  
  
  CONCLUSIONS
  Larger practices were most likely to have adopted HIT, but other factors, including specialty mix and self-reported patient-centered management, had a stronger influence on the use of HIT once adopted.
  
  
  CONCLUSIONS
  Adoption of HIT by practices does not mean that physicians will use the HIT.
authors: Health Services and Policy Analysis Program, University of California, Berkeley, California 94720, USA. smcclellan@berkeley.edu
authors: Sean R
authors: SR
authors: McClellan
authors: Lawrence P
authors: LP
authors: Casalino
authors: Stephen M
authors: SM
authors: Shortell
authors: Diane R
authors: DR
authors: Rittenhouse
mesh_terms: D006801:Humans; D016014:Linear Models; D008490:Medical Informatics / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States
keywords: Physician practices; electronic health records; meaningful use
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