title: Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.
abstract: OBJECTIVE
  Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience.
  
  
  METHODS
  We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice.
  
  
  RESULTS
  The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P < .001). Older physician age is associated with worse opinion of electronic health record introduction (P < .001). Of the 18 electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction.
  
  
  CONCLUSIONS
  We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time.
authors.affiliation: Brown University School of Public Health, Providence, RI. Electronic address: Matthew_Wylie@brown.edu.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Wylie
authors.affiliation: Brown University School of Public Health, Providence, RI; Healthcentric Advisors, Providence, RI.
authors.forename: Rosa R
authors.initials: RR
authors.lastname: Baier
authors.affiliation: Healthcentric Advisors, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Rebekah L
authors.initials: RL
authors.lastname: Gardner
mesh_terms: D000367:Age Factors; D057171:American Recovery and Reinvestment Act; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D010350:Patient Credit and Collection; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D012237:Rhode Island; D013038:Specialization / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States; D057188:Workflow
keywords: Electronic health record; Electronic medical record; Physician experience