Factors associated with difficult electronic health record implementation in office practice

Little is known about physicians' perception of the ease or difficulty of implementing electronic health records (EHR). This study identified factors related to the perceived difficulty of implementing EHR. 163 physicians completed surveys before and after the implementation of EHR in an externally funded pilot program in three Massachusetts communities. Ordinal hierarchical logistic regression was used to identify baseline factors that correlated with physicians' report of difficulty with EHR implementation. Compared with physicians with ownership stake in their practices, physician employees were less likely to describe EHR implementation as difficult (adjusted OR 0.5, 95% CI 0.3 to 1.0). Physicians who perceived their staff to be innovative were also less likely to view EHR implementation as difficult (adjusted OR 0.4, 95% CI 0.2 to 0.8). Physicians who own their practice may need more external support for EHR implementation than those who do not. Innovative clinical support staff may ease the EHR implementation process and contribute to its success.

[1]  Julia Adler-Milstein,et al.  A Survey of Health Information Exchange Organizations in the United States: Implications for Meaningful Use , 2011, Annals of Internal Medicine.

[2]  D. Bates,et al.  Understanding the decisions and values of stakeholders in health information exchanges: experiences from Massachusetts. , 2009, American journal of public health.

[3]  Eric W. Ford,et al.  Predicting the adoption of electronic health records by physicians: when will health care be paperless? , 2006, Journal of the American Medical Informatics Association : JAMIA.

[4]  J. Kalus,et al.  Pharmacologic management of atrial fibrillation: established and emerging options. , 2009, Journal of managed care pharmacy : JMCP.

[5]  Sowmya R. Rao,et al.  Use of electronic health records in U.S. hospitals. , 2009, The New England journal of medicine.

[6]  David W. Bates,et al.  Application of Information Technology: Health Care IT Collaboration in Massachusetts: The Experience of Creating Regional Connectivity , 2005, J. Am. Medical Informatics Assoc..

[7]  Steven R Simon,et al.  The Relationship Between Perceived Practice Quality and Quality Improvement Activities and Physician Practice Dissatisfaction, Professional Isolation, and Work-Life Stress , 2009, Medical care.

[8]  Blackford Middleton,et al.  Viewpoint Paper: Accelerating U.S. EHR Adoption: How to Get There From Here. Recommendations Based on the 2004 ACMI Retreat , 2005, J. Am. Medical Informatics Assoc..

[9]  Steven R. Simon,et al.  Case Report: Community-wide Implementation of Health Information Technology: The Massachusetts eHealth Collaborative Experience , 2009, J. Am. Medical Informatics Assoc..

[10]  Rainu Kaushal,et al.  Physicians and electronic health records: a statewide survey. , 2007, Archives of internal medicine.

[11]  Farzad Mostashari,et al.  A tale of two large community electronic health record extension projects. , 2009, Health affairs.

[12]  Steven R. Simon,et al.  Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey , 2006, AMIA.

[13]  Deborah Aldridge.  Beacon community program. , 2011, Computers, informatics, nursing : CIN.

[14]  Sowmya R. Rao,et al.  Electronic health records in ambulatory care--a national survey of physicians. , 2008, The New England journal of medicine.

[15]  Chelsea A. Jenter,et al.  Readiness for electronic health records: comparison of characteristics of practices in a collaborative with the remainder of Massachusetts. , 2008, Informatics in primary care.