Predicting the Adoption of Electronic Health Records by Physicians: when Will Health Care Be Paperless?

Overview

Journal J Am Med Inform Assoc

Publisher Oxford University Press

Specialty Medical Informatics

Date 2005 Oct 14

PMID 16221936

Citations 61

Authors

Eric W Ford

Nir Menachemi

M Thad Phillips

Affiliations

Soon will be listed here.

Abstract

Objectives: The purpose of this study was threefold. First, we gathered and synthesized the historic literature regarding electronic health record (EHR) adoption rates among physicians in small practices (ten or fewer members). Next, we constructed models to project estimated future EHR adoption trends and timelines. We then determined the likelihood of achieving universal EHR adoption in the near future and articulate how barriers can be overcome in the small and solo practice medical environment.

Design: This study used EHR adoption data from six previous surveys of small practices to estimate historic market penetration rates. Applying technology diffusion theory, three future adoption scenarios, optimistic, best estimate, and conservative, are empirically derived.

Measurement: EHR adoption parameters, external and internal coefficients of influence, are estimated using Bass diffusion models.

Results: All three EHR scenarios display the characteristic diffusion S curve that is indicative that the technology is likely to achieve significant market penetration, given enough time. Under current conditions, EHR adoption will reach its maximum market share in 2024 in the small practice setting.

Conclusion: The promise of improved care quality and cost control has prompted a call for universal EHR adoption by 2014. The EHR products now available are unlikely to achieve full diffusion in a critical market segment within the time frame being targeted by policy makers.

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References

Rittenhouse D, Grumbach K, ONeil E, Dower C, Bindman A . Physician organization and care management in California: from cottage to Kaiser. Health Aff (Millwood). 2004; 23(6):51-62. DOI: 10.1377/hlthaff.23.6.51. View

Heffner J . Altering physician behavior to improve clinical performance. Top Health Inf Manage. 2002; 22(2):1-9. View

Andrews J, Pearce K, Sydney C, Ireson C, Love M . Current state of information technology use in a US primary care practice-based research network. Inform Prim Care. 2004; 12(1):11-8. DOI: 10.14236/jhi.v12i1.103. View

Terry N . Electronic health records: international, structural and legal perspectives. J Law Med. 2004; 12(1):26-39. View

Overhage J, Perkins S, Tierney W, McDonald C . Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices. J Am Med Inform Assoc. 2001; 8(4):361-71. PMC: 130081. DOI: 10.1136/jamia.2001.0080361. View

Menachemi N, Burke D, Brooks R . Adoption factors associated with patient safety-related information technology. J Healthc Qual. 2004; 26(6):39-44. DOI: 10.1111/j.1945-1474.2004.tb00535.x. View

Burt C, Hing E . Use of computerized clinical support systems in medical settings: United States, 2001-03. Adv Data. 2005; (353):1-8. View

Zhang J, Patel V, Johnson T . Medical error: is the solution medical or cognitive?. J Am Med Inform Assoc. 2002; 9(6 Suppl):S75-7. PMC: 419424. DOI: 10.1197/jamia.m1232. View

Loomis G, Ries J, Saywell Jr R, Thakker N . If electronic medical records are so great, why aren't family physicians using them?. J Fam Pract. 2002; 51(7):636-41. View

10.

Bates D, Ebell M, Gotlieb E, Zapp J, Mullins H . A proposal for electronic medical records in U.S. primary care. J Am Med Inform Assoc. 2003; 10(1):1-10. PMC: 150354. DOI: 10.1197/jamia.m1097. View

11.

Reed M, Grossman J . Limited information technology for patient care in physician offices. Issue Brief Cent Stud Health Syst Change. 2004; (89):1-6. View

12.

Leatherman S, Berwick D, Iles D, Lewin L, Davidoff F, Nolan T . The business case for quality: case studies and an analysis. Health Aff (Millwood). 2003; 22(2):17-30. DOI: 10.1377/hlthaff.22.2.17. View

13.

Badger S, Bosch R, Toteja P . Rapid implementation of an electronic health record in an academic setting. J Healthc Inf Manag. 2005; 19(2):34-40. View

14.

Oxman A, Thomson M, Davis D, Haynes R . No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995; 153(10):1423-31. PMC: 1487455. View

15.

Brailer D . EHRs: the Fed's big push. Interview by Ken Terry. Med Econ. 2004; 81(16):26, 28-9. View

16.

Ash J, Bates D . Factors and forces affecting EHR system adoption: report of a 2004 ACMI discussion. J Am Med Inform Assoc. 2004; 12(1):8-12. PMC: 543830. DOI: 10.1197/jamia.M1684. View

17.

Brailer D . National health IT initiative moves into action: an interview with David Brailer. Interview by Carole Bolster. Healthc Financ Manage. 2005; 59(7):92-3. View

18.

Audet A, Doty M, Shamasdin J, Schoenbaum S . Measure, learn, and improve: physicians' involvement in quality improvement. Health Aff (Millwood). 2005; 24(3):843-53. DOI: 10.1377/hlthaff.24.3.843. View

19.

Versel N . Connect the docs. Study shows IT issues could create common ground for physicians and hospitals. Mod Healthc. 2004; 34(8):46-8. View

20.

Levac K . Putting outcomes into practice in physician offices. J Nurs Care Qual. 2002; 17(1):51-62; quiz 90. DOI: 10.1097/00001786-200210000-00007. View