title: Physician satisfaction following electronic health record adoption in three massachusetts communities.
abstract: BACKGROUND
  Despite mandates and incentives for electronic health record (EHR) adoption, little is known about factors predicting physicians' satisfaction following EHR implementation.
  
  
  OBJECTIVE
  To measure predictors of physician satisfaction following EHR adoption.
  
  
  METHODS
  A total of 163 physicians completed a mailed survey before and after EHR implementation through a statewide pilot project in Massachusetts. Multivariable logistic regression identified predictors of physician satisfaction with their current practice situation in 2009 and generalized estimating equations accounted for clustering.
  
  
  RESULTS
  The response rate was 77% in 2005 and 68% in 2009. In 2005, prior to EHR adoption, 28% of physicians were very satisfied with their current practice situation compared to 25% in 2009, following EHR adoption (P < .001). In multivariate analysis, physician satisfaction following EHR adoption was correlated with self-reported ease of EHR implementation (adjusted odds ratio [OR] = 5.7, 95% CI 2.1 - 16), resources for practice improvement (adjusted OR = 2.6, 95% CI 1.2 - 6.1), pre-intervention satisfaction (adjusted OR = 4.8, 95% CI 1.5 - 15), and stress (adjusted OR = 5.3, 95% CI 1.1 - 25). Male physicians reported lower satisfaction following EHR adoption (adjusted OR = 0.3, 95% CI 0.2 - 0.6).
  
  
  CONCLUSIONS
  Interventions to expand EHR use should consider additional support for practices with fewer resources for improvement and ensure ease of EHR implementation. EHR adoption may be a factor in alleviating physicians' stress. Addressing physicians' satisfaction prior to practice transformation and anticipating greater dissatisfaction among male physicians will be essential to retaining the physician workforce and ensuring the quality of care they deliver.
authors.affiliation: VA Boston Healthcare System, Section of General Internal Medicine, Jamaica Plain, MA, United States. lheyworth@gmail.com.
authors.forename: Leonie
authors.initials: L
authors.lastname: Heyworth
authors.forename: Fang
authors.initials: F
authors.lastname: Zhang
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Jenter
authors.forename: Rachel
authors.initials: R
authors.lastname: Kell
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.forename: Micky
authors.initials: M
authors.lastname: Tripathi
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
keywords: Massachusetts eHealth collaborative; electronic health record; implementation; physician satisfaction