Physician beliefs about the impact of meaningful use of the EHR A Cross-Sectional Study

被引:20
作者
Emani, S. [1 ]
Ting, D. Y. [2 ]
Healey, M. [1 ,3 ]
Lipsitz, S. R. [1 ]
Karson, A. S. [4 ]
Einbinder, J. S. [1 ]
Leinen, L. [5 ]
Suric, V. [1 ]
Bates, D. W. [1 ,6 ]
机构
[1] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Gen Internal Med,Dept Med, Boston, MA 02115 USA
[2] Massachusetts Gen Hosp, Massachusetts Gen Phys Org, Boston, MA 02114 USA
[3] Brigham & Womens Hosp, Brigham & Womens Phys Org, Boston, MA 02120 USA
[4] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Decis Support Unit, Boston, MA USA
[5] Partners HealthCare, Informat Serv, Boston, MA USA
[6] Harvard Univ, Sch Publ Hlth, Dept Healthcare Policy & Management, Boston, MA 02115 USA
关键词
Electronic health records; physicians; beliefs; meaningful use; evaluation; ELECTRONIC HEALTH RECORDS; INFORMATION-TECHNOLOGY; ADOPTION; GUIDELINES; QUALITY; SYSTEMS; CARE;
D O I
10.4338/ACI-2014-05-RA-0050
中图分类号
R-058 [];
学科分类号
摘要
Background: As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs. Objective: Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care. Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program. Results: Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e. g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items. Conclusions: Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.
引用
收藏
页码:789 / 801
页数:13
相关论文
共 26 条
[1]   The Meaningful Use Regulations in Information Technology: What Do They Mean for Quality Improvement in Hospitals? [J].
Abbett, Sarah K. ;
Bates, David W. ;
Kachalia, Allen .
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY, 2011, 37 (07) :333-336
[2]   SELF-EFFICACY - TOWARD A UNIFYING THEORY OF BEHAVIORAL CHANGE [J].
BANDURA, A .
PSYCHOLOGICAL REVIEW, 1977, 84 (02) :191-215
[3]  
Bandura A., 1986, Social Foundations of Thought and Action: A Social Cognitive Theory, DOI DOI 10.5465/AMR.1987.4306538
[4]   The "Meaningful Use" Regulation for Electronic Health Records [J].
Blumenthal, David ;
Tavenner, Marilyn .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (06) :501-504
[5]   Health Information Technology: Laying The Infrastructure For National Health Reform [J].
Buntin, Melinda Beeuwkes ;
Jain, Sachin H. ;
Blumenthal, David .
HEALTH AFFAIRS, 2010, 29 (06) :1214-1219
[6]   Why don't physicians follow clinical practice guidelines? A framewouk for improvement [J].
Cabana, MD ;
Rand, CS ;
Powe, NR ;
Wu, AW ;
Wilson, MH ;
Abboud, PAC ;
Rubin, HR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (15) :1458-1465
[7]   Physician adherence to preventive cardiology guidelines for women [J].
Cabana, MD ;
Kim, C .
WOMENS HEALTH ISSUES, 2003, 13 (04) :142-149
[8]   Special Requirements for Electronic Health Record Systems in Ophthalmology [J].
Chiang, Michael F. ;
Boland, Michael V. ;
Brewer, Allen ;
Epley, K. David ;
Horton, Mark B. ;
Lim, Michele C. ;
McCannel, Colin A. ;
Patel, Sayjal J. ;
Silverstone, David E. ;
Wedemeyer, Linda ;
Lum, Flora .
OPHTHALMOLOGY, 2011, 118 (08) :1681-1687
[9]   Physicians In Nonprimary Care And Small Practices And Those Age 55 And Older Lag In Adopting Electronic Health Record Systems [J].
Decker, Sandra L. ;
Jamoom, Eric W. ;
Sisk, Jane E. .
HEALTH AFFAIRS, 2012, 31 (05) :1108-1114
[10]   Meeting Meaningful Use Criteria and Managing Patient Populations A National Survey of Practicing Physicians [J].
DesRoches, Catherine M. ;
Audet, Anne-Marie ;
Painter, Michael ;
Donelan, Karen .
ANNALS OF INTERNAL MEDICINE, 2013, 158 (11) :791-+