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A Statewide Survey

Steven R. Simon, MD, MPH; Rainu Kaushal, MD, MPH; Paul D. Cleary, PhD; Chelsea A. Jenter, MPH; Lynn A. Volk, MHS; E. John Orav, PhD; Elisabeth Burdick, MS; Eric G. Poon, MD, MPH; David W. Bates, MSc, MD

Arch Intern Med. 2007;167(5):507-512.

Background  Electronic health records (EHRs) allow for a variety of functions, ranging from visit documentation to laboratory test ordering, but little is known about physicians' actual use of these functions.

Methods  We surveyed a random sample of 1884 physicians in Massachusetts by mail and assessed availability and use of EHR functions, predictors of use, and the relationships between EHR use and physicians' perceptions of medical practice.

Results  A total of 1345 physicians responded to the survey (71.4% response rate), and 387 (28.8%) reported that their practice had adopted EHRs. More than 80% of physicians with EHRs reported having the ability to view laboratory reports (84.8%) and document visits electronically (84.0%), but considerably fewer reported being able to order laboratory tests electronically (46.8%) or transmit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision support, transmittal of electronic prescriptions, and radiology order entry actually used these functions most or all of the time. Compared with physicians who had not adopted EHRs, EHR users reported more positive views of the effects of computers on health care; there were no significant differences in these attitudes between high and low users of EHRs. Overall, about 1 in 4 physicians reported dissatisfaction with medical practice; there was no difference in this measure by EHR adoption or use.

Conclusions  There is considerable variability in the functions available in EHRs and in the extent to which physicians use them. Future work should emphasize factors that affect the use of available functions.

Author Affiliations: Departments of Ambulatory Care and Prevention (Dr Simon) and Health Care Policy (Dr Cleary), Harvard Medical School and Harvard Pilgrim Health Care (Dr Simon); Division of General Internal Medicine, Brigham and Women's Hospital (Drs Kaushal, Orav, and Bates, and Mss Jenter and Burdick); and Department of Clinical and Quality Analysis, Partners HealthCare System, Inc (Ms Volk and Drs Poon and Bates), Boston, Mass.