TY - JOUR
T1 - Clinician characteristics and use of novel electronic health record functionality in primary care
AU - Linder, Jeffrey A.
AU - Rigotti, Nancy A.
AU - Schneider, Louise I.
AU - Kelley, Jennifer H K
AU - Brawarsky, Phyllis
AU - Schnipper, Jeffrey L.
AU - Middleton, Blackford
AU - Haas, Jennifer S.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Conventional wisdom holds that older, busier clinicians who see complex patients are less likely to adopt and use novel electronic health record (EHR) functionality. Methods: To compare the characteristics of clinicians who did and did not use novel EHR functionality, we conducted a retrospective analysis of the intervention arm of a randomized trial of new EHR-based tobacco treatment functionality. Results: The novel functionality was used by 103 of 207 (50%) clinicians. Staff physicians were more likely than trainees to use the functionality (64% vs 37%; p<0.001). Clinicians who graduated more than 10 years previously were more likely to use the functionality than those who graduated less than 10 years previously (64% vs 42%; p<0.01). Clinicians with higher patient volumes were more likely to use the functionality (lowest quartile of number of patient visits, 25%; 2nd quartile, 38%; 3rd quartile, 65%; highest quartile, 71%; p<0.001). Clinicians who saw patients with more documented problems were more likely to use the functionality (lowest tertile of documented patient problems, 38%; 2nd tertile, 58%; highest tertile, 54%; p=0.04). In multivariable modeling, independent predictors of use were the number of patient visits (OR 1.2 per 100 additional patients; 95% CI 1.1 to 1.4) and number of documented problems (OR 2.9 per average additional problem; 95% CI 1.4 to 6.1). Conclusions: Contrary to conventional wisdom, clinically busier physicians seeing patients with more documented problems were more likely to use novel EHR functionality.
AB - Background: Conventional wisdom holds that older, busier clinicians who see complex patients are less likely to adopt and use novel electronic health record (EHR) functionality. Methods: To compare the characteristics of clinicians who did and did not use novel EHR functionality, we conducted a retrospective analysis of the intervention arm of a randomized trial of new EHR-based tobacco treatment functionality. Results: The novel functionality was used by 103 of 207 (50%) clinicians. Staff physicians were more likely than trainees to use the functionality (64% vs 37%; p<0.001). Clinicians who graduated more than 10 years previously were more likely to use the functionality than those who graduated less than 10 years previously (64% vs 42%; p<0.01). Clinicians with higher patient volumes were more likely to use the functionality (lowest quartile of number of patient visits, 25%; 2nd quartile, 38%; 3rd quartile, 65%; highest quartile, 71%; p<0.001). Clinicians who saw patients with more documented problems were more likely to use the functionality (lowest tertile of documented patient problems, 38%; 2nd tertile, 58%; highest tertile, 54%; p=0.04). In multivariable modeling, independent predictors of use were the number of patient visits (OR 1.2 per 100 additional patients; 95% CI 1.1 to 1.4) and number of documented problems (OR 2.9 per average additional problem; 95% CI 1.4 to 6.1). Conclusions: Contrary to conventional wisdom, clinically busier physicians seeing patients with more documented problems were more likely to use novel EHR functionality.
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U2 - 10.1136/amiajnl-2011-000330
DO - 10.1136/amiajnl-2011-000330
M3 - Article
C2 - 21900702
AN - SCOPUS:84865286920
SN - 1067-5027
VL - 18
SP - 87
EP - 90
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
IS - SUPPL. 1
ER -