title: EHR adoption among ambulatory care teams.
abstract: OBJECTIVE
  This study provides information on the types of practices that employ 2 types of advance practice providers (APPs), nurse practitioners (NPs) and physician assistants (PAs), and the association between employment of APPs and health information technology (IT) adoption by the practice.
  
  
  METHODS
  Three outcomes predicted the likelihood that practices employed at least 1 NP, at least 1 PA, or at least 1 of either type of APP; one outcome estimated electronic health record (EHR) adoption across practices; and 4 models assessed the EHR functionalities used by practices.
  
  
  METHODS
  Data from SK and A Information Services' 2013 Office-Based Provider Database were used to estimate EHR adoption using a Poisson regression model. Independent variables included practice size, care setting, practice specialty, ownership, geographic region, whether a practice employed a NP, and whether a practice employed a PA.
  
  
  RESULTS
  In 2013, three-fourths of practices that employed at least 1 APP had adopted an EHR. Practices that employed at least 1 APP were 9% to 12% more likely to have an EHR that had advanced functionalities, compared with practices without an APP.
  
  
  CONCLUSIONS
  This study found an association between employment of APP staff and practice-level adoption of EHRs and practice-level adoption of certain EHR functionalities. Practices that employ APPs are prepared to implement team-based approaches to care that may be further enhanced through the use of health IT. Future research should examine how practices with APPs are using health IT to promote better health and coordinate care.
authors.affiliation: US Department of Health and Human Services, Office of the National Coordinator for Health IT, 200 Independence Ave, SW, Ste 745H.3, Washington, DC 20201. E-mail: Wesley.Barker@hhs.gov.
authors.forename: Philip Wesley
authors.initials: PW
authors.lastname: Barker
authors.forename: Dawn Marie
authors.initials: DM
authors.lastname: Heisey-Grove
mesh_terms: D000553:Ambulatory Care; D001292:Attitude to Computers; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D009722:Nurse Practitioners; D010823:Physician Assistants; D011216:Practice Management, Medical; D014481:United States