Factors Related to Physicians’ Adoption of Electronic Prescribing: Results From a National Survey

Pizzi, Laura T.; Suh, Dongchul; Barone, Joseph G.; Nash, David B.

doi:10.1177/1062860604273775

Cited by 59 publications

(66 citation statements)

References 12 publications

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“…Moreover, ambulatory care in the German language region is increasingly characterized by the formation of medical networks that goes along with a higher demand for information exchange among healthcare Previous studies in this field suggested that health IT adoption is also associated with age and sex [5,14,16,29,[49][50][51]. Our results suggest that young age (30−39 years) and male sex are predictors of EHR adoption but have only limited impact on the adoption of the surveyed electronic workflows supporting health data exchange.…”

Section: Discussionmentioning

confidence: 46%

Undirected health IT implementation in ambulatory care favors paper-based workarounds and limits health data exchange

Djalali

Rosemann

Senn

et al. 2015

International Journal of Medical Informatics

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BACKGROUND: The adoption and use of health information technology (IT) continues to grow around the globe. In Switzerland, the government nor professional associations have to this day provided incentives for health IT adoption. OBJECTIVE: We aim to assess the proportion of physicians who are routinely working with electronic health data and describe to what extent physicians exchange electronic health data with peers and other health care providers. Additionally, we aim to estimate the effect of physicians' attitude towards health IT on the adoption of electronic workflows. METHODS: Between May and July 2013, we conducted a cross-sectional survey of 1200 practice based physicians in Switzerland. Respondents were asked to report on their technical means and where applicable their paper-based workarounds to process laboratory data, examination results, referral letters and physician's letters. Physicians' view of barriers and facilitators towards health IT use was determined by a composite score. RESULTS: A response rate of 57.1% (n=685) was reached. The sample was considered to be representative for physicians in Swiss ambulatory care. 35.2% of the respondents documented patients' health status with the help of a longitudinal semi-structured electronic text record generated by one or more encounters in the practice. Depending on the task within a workflow, around 11-46% of the respondents stated to rely on electronic workflow practices to process laboratory and examination data and dispatch referral notes and physician's letters. The permanent use of electronic workflow processes was infrequent. Instead, respondents reported paper-based workarounds affecting specific tasks within a workflow. Physicians' attitude towards health IT was significantly associated with the adoption of electronic workflows (OR 1.04-1.31, p<0.05), but the effect sizes of factors related to the working environment (e.g., regional factors, medical specialty, type of practice) were larger. CONCLUSION: At present, only a few physicians in Swiss ambulatory care routinely work with electronic health data. Until more of their peers participate in electronic exchange of structured clinical information, most physicians will continue to stay in paper-based systems and workarounds. The survey found that physicians with a positive attitude towards health IT were more likely to adopt electronic workflows, but the impact is minor. It will likely be necessary to introduce financial incentives and develop national standards in order to promote the adoption by a critical mass of practicing clinicians. Abstract BackgroundThe adoption and use of health information technology (IT) continues to grow around the globe. In Switzerland, the government nor professional associations have to this day provided incentives for health IT adoption. ObjectiveWe aim to assess the proportion of physicians who are routinely working with electronic health dataand describe to what extent physicians exchange electronic health data with peers and other health care p...

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Section: Discussionmentioning

confidence: 46%

Undirected health IT implementation in ambulatory care favors paper-based workarounds and limits health data exchange

Djalali

Rosemann

Senn

et al. 2015

International Journal of Medical Informatics

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“…20,21 Commonly identified barriers to health information technologies (HIT) such as e-prescribing include expected productivity loss and a lack of time to learn about new systems, 22 as well as increased costs, the effort needed to adapt office systems, and technical difficulties. 23 Once installed, HIT may be used inconsistently or in unexpected ways, and several studies have documented that HIT usage does not easily translate into better care in typical ambulatory care settings. [24][25][26] Choices made during HIT implementation may lead to technology usage that is substantially different from that envisioned by designers and policy makers.…”

Section: Introductionmentioning

confidence: 99%

Variation in Electronic Prescribing Implementation Among Twelve Ambulatory Practices

et al. 2008

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BACKGROUND: Electronic prescribing has been advocated as an important tool for improving the safety and quality of medication use in ambulatory settings. However, widespread adoption of e-prescribing in ambulatory settings has yet to be realized. The determinants of successful implementation and use in these settings are not well understood. OBJECTIVE:To describe the practice characteristics associated with implementation and use of e-prescribing in ambulatory settings. DESIGN:Multi-method qualitative case study of ambulatory practices before and after e-prescribing implementation.PARTICIPANTS: Sixteen physicians and 31 staff members working in 12 practices scheduled for implementation of an e-prescribing program and purposively sampled to ensure a mix of practice size and physician specialty. MEASUREMENTS:Field researchers used observational and interview techniques to collect data on prescriptionrelated clinical workflow, information technology experience, and expectations. RESULTS:Five practices fully implemented e-prescribing, 3 installed but with only some prescribers or staff members using the program, 2 installed and then discontinued use, 2 failed to install. Compared to practice members in other groups, members of successful practices exhibited greater familiarity with the capabilities of health information technologies and had more modest expectations about the benefits likely to accrue from e-prescribing. Members of unsuccessful practices reported limited understanding of e-prescribing capabilities, expected that the program would increase the speed of clinical care and reported difficulties with technical aspects of the implementation and insufficient technical support. CONCLUSIONS:Practice leaders should plan implementation carefully, ensuring that practice members prepare for the effective integration of this technology into clinical workflow.KEY WORDS: electronic prescribing; medical informatics; qualitative research; health services research.

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“…[21][22][23] The final rate of 27.5% in the second quarter of 2010 likely represents an increased interest in eRx in the community because of several factors, such as meaningful use standards, increased adoption of EHRs within New York City, and a variety of incentive programmes through New York State and the federal government.…”

Section: Comparison With the Literaturementioning

confidence: 99%

Study of electronic prescribing rates and barriers identified among providers using electronic health records in New York City

Amirfar¹,

Anane²,

Buck³

et al. 2011

Journal of Innovation in Health Informatics

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Background Increased electronic prescribing (eRx) rates have the potential to prevent errors, increase patient safety, and curtail fraud. US Federal meaningful use guidelines require at least a 40% electronic prescribing rate. Objective We evaluated eRx rates among primary care providers in New York City in order to determine trends as well as identify any obstacles to increased eRx rates required by meaningful use guidelines.

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Factors Related to Physicians’ Adoption of Electronic Prescribing: Results From a National Survey

Cited by 59 publications

References 12 publications

Undirected health IT implementation in ambulatory care favors paper-based workarounds and limits health data exchange

Undirected health IT implementation in ambulatory care favors paper-based workarounds and limits health data exchange

Variation in Electronic Prescribing Implementation Among Twelve Ambulatory Practices

Study of electronic prescribing rates and barriers identified among providers using electronic health records in New York City

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