title: The good, the bad and the early adopters: providers' attitudes about a common, commercial EHR.
abstract: OBJECTIVE
  To describe primary care providers' (PCP) attitudes about the impact of a mature, commercial electronic health records (EHR) on clinical practice in settings with experience using the system and to evaluate whether a provider's propensity to adopt new technologies is associated with more favourable perceptions.
  
  
  METHODS
  We surveyed PCPs in 11 practices affiliated with three health systems in Texas. Most practices had greater than 5 years of experience with the Epic EHR. The effect of early adopter of technology status was evaluated using logistic regression.
  
  
  RESULTS
  One hundred forty-six PCPs responded (70%). Most thought the EHR had a positive impact on routine tasks, such as prescription refills (94%), whereas fewer agreed for complex tasks, such as delivery of guideline-concordant care for chronic illnesses (51%). Two-thirds (62%) thought it interfered with eye contact with patients, and 40% reported that it interfered with in-visit communication. Early adopters of technology reported greater positive effects of the EHR, even after adjusting for age, ranging from 2% to 15% higher on satisfaction ratings.
  
  
  CONCLUSIONS
  PCPs practicing in settings with considerable experience using a common commercial EHR identified many positive effects, as well as two key areas for improvement - patient centredness and intelligent decision support. Providers with a propensity to adopt new technologies have more favourable perceptions of the EHR.
authors: Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Anil N
authors: AN
authors: Makam
authors: Holly J
authors: HJ
authors: Lanham
authors: Kim
authors: K
authors: Batchelor
authors: Brett
authors: B
authors: Moran
authors: Temple
authors: T
authors: Howell-Stampley
authors: Lynne
authors: L
authors: Kirk
authors: Manjula
authors: M
authors: Cherukuri
authors: Lipika
authors: L
authors: Samal
authors: Noel
authors: N
authors: Santini
authors: Luci K
authors: LK
authors: Leykum
authors: Ethan A
authors: EA
authors: Halm
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011787:Quality of Health Care
keywords: attitude of health personnel; attitude to computers; early adopter; electronic health record; physicians; primary care; primary health care