Barriers to ambulatory EHR: who are 'imminent adopters' and how do they differ from other physicians?

Record media used by primary care providers in medically underserved regions of upstate New York was not pivotal to clinical result in the Informatics for Diabetes Education and Telemedicine (IDEATel) project

“…29,30,43 Cost was the most common inhibitor to instituting EMR, but was prime for only one third of this sample of PCPs. Although underpowered, results for the small sample of PCPs interviewed in depth in this survey showed no relationship between EMR access and intermediary outcomes of diabetes for their patients enrolled in home telemedicine-based case management (IDEATel).…”

“…'mass-customisation') in response to wide variability in PCPs' management of medical records may blunt differentiation of new system benefits from those of legacy systems, and may be counterproductive to the pursuit of more standardsbased elegance that could foster EMR interoperability. This in-depth survey suggests that PCPs in rural, underserved areas may be too dispersed geographically to be reached with compelling frequency with an insular, branded-product sales model by the current plethora 29 of mainly boutique-sized, modestly capitalised 30 medical HIT vendors. For example, 39% of responding PCPs interviewed in depth, in person had not had a single qualified sales presentation for an EMR product within the previous six months (range 0-5).…”

“…For similar reasons, the smaller networks of employed PCPs supported by dispersed, predominantly rural populations may choose not to upgrade early efforts at digitisation to attain a comprehensive, emulated (CMR), or frank EMR. Acquisition and maintenance costs, or even too many similar product choices, have been identified as reasons for slow adoption 29,30 of HIT including EMRs in primary care. EMR vendors' value proposition of 'flexibility' (i.e.…”

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

“…[11][12][13][14][15][16][17][18] A few studies investigate attitudes toward EHR adoption in inpatient 19 and academic ambulatory care settings. 20 Some have investigated adoption readiness using statewide survey samples of medical practices, [21][22][23][24] others have assessed physicians' perceptions of quality of care. 25 We know of no reports describing the attitudes and behaviours that predict EHR adoption, specifically e-prescribing adoption, in the primary care setting of an independent medical group.…”

Trends in Primary Care Clinician Perceptions of a New Electronic Health Record

“…9,10 Despite their promise, the adoption of electronic health records remains sluggish, with only one-quarter of ambulatory practices in the US reporting their routine use. 11 Barriers to widespread electronic health record adoption include substantial costs, 8,[12][13][14] as well as the need to significantly redesign workflows, provide extensive training and education, and a potential loss of clinical efficiency. 12,15,16 Clinician perceptions of these issues, as well as the perceived impact the electronic health record has on patient care, are important determinants of the success of a new implementation, [17][18][19] with some highprofile examples of failed implementation as a result of clinician dissatisfaction with the system.…”