title: Where are we on the diffusion curve? Trends and drivers of primary care physicians' use of health information technology.
abstract: OBJECTIVE
  To describe trends in primary care physicians' use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality.
  
  
  METHODS
  We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States.
  
  
  METHODS
  We compared primary care physicians' HIT capacity in 2009 and 2012. We employed multivariable logistic regression to analyze whether participating in an integrated delivery system, sharing resources and support with other practices, and being eligible for financial incentives were associated with greater HIT capacity in 2012.
  
  
  RESULTS
  Primary care physicians' HIT capacity has significantly expanded since 2009, although solo practices continue to lag. Practices that are part of an integrated delivery system or share resources with other practices have higher rates of electronic medical record (EMR) adoption, multifunctional HIT, electronic information exchange, and electronic access for patients. Receiving or being eligible for financial incentives is associated with greater adoption of EMRs and information exchange.
  
  
  CONCLUSIONS
  Federal efforts to increase adoption have coincided with a rapid increase in HIT capacity. Delivery system and payment reforms and federally funded extension programs could offer promising pathways for further diffusion.
authors.affiliation: Delivery System Reform & Breakthrough Opportunities, The Commonwealth Fund, New York, NY.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Audet
authors.forename: David
authors.initials: D
authors.lastname: Squires
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Doty
mesh_terms: D003625:Data Collection; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D008490:Medical Informatics / Q000639:trends*; D058007:Physicians, Primary Care / Q000706:statistics & numerical data* / Q000639:trends*; D012052:Reimbursement, Incentive / Q000706:statistics & numerical data*; D058012:Small Business / Q000706:statistics & numerical data*; D014481:United States
keywords: EMR adoption; financial incentives; health information exchange; primary care physicians; shared resources; small physician practices