title: Meaningful Use of the Indian Health Service Electronic Health Record.
abstract: To understand the use of electronic health record (EHR) functionalities by physicians practicing in an underserved setting.
  
  
  
  A total of 333 Indian Health Service physicians (55 percent response rate) in August 2012.
  
  
  
  Cross-sectional.
  
  
  
  The survey assessed routine use of EHR functionalities, perceived usefulness, and barriers to adoption.
  
  
  
  Physicians routinely used a median 7 of 10 EHR functionalities targeted by the Meaningful Use program, but only 5 percent used all 10. Most (63 percent) felt the EHR improved quality of care. Many (76 percent) reported increased documentation time and poorer quality patient-physician interactions (45 percent). Primary care specialty and time using the EHR were positively associated with use of EHR functionalities, while perceived productivity loss was negatively associated.
  
  
  
  Significant opportunities exist to increase use of EHR functionalities and preserve physician-patient interactions and productivity in a resource-limited environment.
authors.affiliation: Harvard Medical School, Boston, MA.
authors.forename: Gina R
authors.initials: GR
authors.lastname: Kruse
authors.affiliation: Apex Data Solutions, LLC, Tampa, FL.
authors.forename: Howard
authors.initials: H
authors.lastname: Hays
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.affiliation: Westat, Rockville, MD.
authors.forename: Martha
authors.initials: M
authors.lastname: Palan
authors.affiliation: Partners HealthCare System, Boston, MA.|Department of Health Care Policy, Harvard Medical School, Boston, MA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Sequist
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D062527:Meaningful Use; D008875:Middle Aged; D014481:United States; D016549:United States Indian Health Service
keywords: Electronic health record; Indian Health Service; Meaningful Use; underserved