Assessing attitudes toward electronic prescribing adoption in primary care: a survey of prescribers and staff.

BACKGROUND Using survey instruments to assess physicians' attitudes toward electronic health record (EHR) adoption has been an ongoing area of research. No instrument has emerged for widespread use. OBJECTIVE We used a theoretically-based, 37-question survey instrument to assess attitudes toward electronic (e-) prescribing adoption in the context of an existing EHR. Our objective was to elicit information to inform strategies to maximise adoption. METHODS The instrument assesses attitudes in four domains: finesse, intent to use technology, perceived usefulness and perceived ease of use. Two additional questions ask about computer use at home and self-assessed computer knowledge. We administered the instrument to prescribers and staff at three primary care sites between 2005 and 2007. Each site represented a unique transition from paper-based or partial (Phase 1) to full (Phase 2) e-prescribing use. RESULTS Fifty-nine prescribers (82% response) and 58 staff (50% response) completed the survey. At the paper-based site, domain scores increased significantly from Phase 1 to Phase 2 for intent to use technology for both prescribers (4.8 to 5; P<0.04) and staff (4 to 5; P<0.03); and for perceived usefulness for staff (3.7 to 4.6; P<0.02). For prescribers, significant associations (P<0.05) were found between computer use at home for professional use and each domain score; and between computer knowledge and three of the four domains. Self-assessed computer knowledge was consistently rated as intermediate, vs novice or expert. CONCLUSIONS Domain scores improved. Prescribers' self-assessment of computer use at home and computer knowledge predicted attitudes toward adoption. This instrument may be useful in tailoring strategies for successful adoption.