Does it Get Easier to Use an EHR? Report from an Urban Regional Extension Center
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Little is known about whether more experience with an electronic health record (EHR) makes it easier for providers to meaningfully use EHRs.
To assess whether the length of time that small practice providers have been using the EHR is associated with greater ease in performing meaningful use-related tasks and fewer EHR-related concerns.
We administered a web-based survey to 400 small practice providers in medically underserved communities in New York City participating in an EHR implementation and technical assistance project. We used logistic regression to estimate the association between the length of time a provider had been using the EHR (i.e., “live”) and the ease of performing meaningful use-related tasks and EHR-related concerns, controlling for provider and practice characteristics.
Compared to providers who had been live 6 to 12 months, providers who had been live 2 years or longer had 2.02 times greater odds of reporting it was easy to e-prescribe new prescriptions (p < 0.05), 2.12 times greater odds of reporting it was easy to e-prescribe renewal prescriptions (p < 0.05), 2.02 times greater odds of reporting that quality measures were easy to report (p < 0.05), 2.64 times greater odds of reporting it was easy to incorporate lab results as structured data (p < 0.001), and 2.00 times greater odds of reporting it was easy to generate patient lists by condition (p < 0.05). Providers who had been live 2 years or longer had 0.40 times lower odds of reporting financial costs were a concern (p < 0.001), 0.46 times lower odds of reporting that productivity loss was a concern (p < 0.05), 0.54 times lower odds of reporting that EHR unreliability was a concern (p < 0.05), and 0.50 times lower odds of reporting that privacy/security was a concern (p < 0.05).
Providers can successfully adjust to the EHR and over time are better able to meaningfully use the EHR.
- Hing E, Burt CW. Office-Based Medical Practices: methods and Estimates From the National Ambulatory Medical Care Survey. Adv Data, No 383. Hyattsville, MD: National Center for Health Statistics; 2007.
- Hsiao CJ, Hing E, Socey TC, Cai B. Electronic Health Record Systems and Intent to Apply for Meaningful use Incentives Among Office-Based Physician Practices: United States, 2001–2011. NCHS Data Brief, No 79. Hyattsville, MD: National Center for Health Statistics; 2011:2011.
- King J, Patel V, Furukawa MF. Physician Adoption of Electronic Health Record Technology to Meet Meaningful use Objectives: 2009–2012. ONC Data Brief, No. 7. Washington, DC: Office of the National Coordinator for Health Information Technology; 2012.
- Patel V, Jamoom E, Hsiao CJ, Furukawa MF, Buntin M. Variation in electronic health record adoption and readiness for meaningful use: 2008–2011. J Gen Intern Med. 2013;28:957–64. CrossRef
- Simon SR, Kaushal R, Cleary PD, et al. Correlates of electronic health record adoption in office practices: a statewide survey. J Am Med Inform Assoc. 2007;14:110–7. CrossRef
- Rao SR, Desroches CM, Donelan K, Campbell EG, Miralles PD, Jha AK. Electronic health records in small physician practices: availability, use, and perceived benefits. J Am Med Inform Assoc. 2011;18:271–5. CrossRef
- Decker SL, Jamoom EW, Sisk JE. Physicians in nonprimary care and small practices and those age 55 and older lag in adopting electronic health record systems. Health Aff (Millwood). 2012;31:1108–14. CrossRef
- Jamoom E, Beatty P, Bercovitz A, Woodwell D, Palso K, Rechtsteiner E. Physician Adoption of Electronic Health Record Systems: United States, 2011. NCHS Data Brief, No 98. Hyattsville: National Center for Health Statistics; 2011:2012.
- Mostashari F, Tripathi M, Kendall M. A tale of two large community electronic health record extension projects. Health Aff (Millwood). 2009;28:345–56. CrossRef
- Maxson E, Jain S, Kendall M, Mostashari F, Blumenthal D. The regional extension center program: helping physicians meaningfully use health information technology. Ann Intern Med. 2010;153:666–70. CrossRef
- Blumenthal D, Tavenner M. The “Meaningful Use” regulation for electronic health records. N Engl J Med. 2010;363:501–4. CrossRef
- DesRoches CM, Campbell EG, Rao SR, et al. Electronic health records in ambulatory care—a national survey of physicians. N Engl J Med. 2008;359:50–60. CrossRef
- Lee J, Cain C, Young S, Chockley N, Burstin H. The adoption gap: health information technology in small physician practices. Health Aff (Millwood). 2005;24:1364–6. CrossRef
- Landon BE, Normand ST. Performance measurement in the small office practice: challenges and potential solutions. Ann Intern Med. 2008;148:353–7. CrossRef
- Messeri P, Khan S, Millery M, et al. An information systems model of the determinants of electronic health record use. Appl Clin Inform. 2013;4:185–200. CrossRef
- DesRoches CM, Audet AM, Painter M, Donelan K. Meeting meaningful use criteria and managing patient populations: a national survey of practicing physicians. Ann Intern Med. 2013;158:791–9. CrossRef
- Jamieson S. Likert scales: how to (ab)use them. Med Educ. 2004;38(12):1217–8. CrossRef
- SAS Institute. SAS Software version 9.2 Cary, NC: SAS Institute Inc; 2002–2008.
- Hsiao CJ, Jha AK, King J, Patel V, Furukawa MF, Mostashari F. Office-based physicians are responding to incentives and assistance by adopting and using electronic health records. Health Aff (Millwood). 2013;32:1470–7. CrossRef
- Heisey-Grove D, Danehy LN, Consolazio M, Lynch K, Mostashari F. A national study of challenges to electronic health record adoption and meaningful use. Med Care. 2014;52(2):144–8. CrossRef
- Government Health IT. EHR Makers Surprised by Stage 2 Complexity. Available at: http://www.govhealthit.com/news/vendors-struggle-mu-stage-2-EHR-ONC. Accessed 18 April 2014.
- Friedberg MW, Chen PG, Van Busum KR, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy. 2013; RR-439-AMA. Available at http://www.rand.org/pubs/research_reports/RR439.html. Accessed 18 April 2014.
- Hsiao CJ, Decker SL, Hing E, Sisk JE. Most physicians were eligible for federal incentives in 2011, but few had EHR systems that met meaningful-use criteria. Health Aff (Millwood). 2012;31:1100–7. CrossRef
- Gold M, Hossain M, Charles DR, Furukawa MF. Evolving vendor market for HITECH-certified ambulatory EHR products. Am J Manage Care. 2013;19(11 Spec No. 10):SP353–61.
- Ryan AM, Bishop TF, Shih S, Casalino LP. Small physician practices in New York needed sustained help to realize gains in quality from use of electronic health records. Health Aff (Millwood). 2012;32:53–62. CrossRef
- Hysong SJ, Best RG, Pugh JA. Clinical practice guideline implementation strategy patterns in Veterans Affairs primary care clinics. Health Serv Res. 2007;42:84–103. CrossRef
- Chen C, Garrido T, Chock D, Okawa G, Liang L. The Kaiser Permanente electronic health record: transforming and streamlining modalities of care. Health Aff (Millwood). 2009;28:323–33. CrossRef
- Gao J, Moran E, Almenoff PL, Render ML, Campbell J, Jha AK. Variations in efficiency and the relationship to quality of care in the Veterans Health System. Health Aff (Millwood). 2011;30:655–63. CrossRef
- Lee TH, Bothe A, Steele GD. How Geisinger structures its physicians’ compensation to support improvements in quality, efficiency, and volume. Health Aff. 2012;31:2068–73. CrossRef
- Fleming NS, Culler SD, McCorkle R, Becker ER, Ballard DJ. The financial and nonfinancial costs of implementing electronic health records in primary care practices. Health Aff (Millwood). 2011;30:481–9. CrossRef
- Office of the National Coordinator. Meaningful Use Stage 2. Available at: http://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2. Accessed 18 April 2014.
- El-Kareh R, Gandhi TK, Poon EG, et al. Trends in primary care clinician perceptions of a new electronic health record. J Gen Intern Med. 2009;24:464–8. CrossRef
- Kanzaria HK, Brook RH. The silent physician. J Gen Intern Med. 2013;28:1389–91. CrossRef
- Does it Get Easier to Use an EHR? Report from an Urban Regional Extension Center
Journal of General Internal Medicine
Volume 29, Issue 10 , pp 1341-1348
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- electronic health records
- primary care
- population health
- physician satisfaction
- vulnerable populations
- Industry Sectors