Person:

Orav, Endel

Background: Electronic health records (EHRs) allow for a variety of functions, ranging from visit documen- tation to laboratory test ordering, but little is known about physicians’ actual use of these functions. Methods: We surveyed a random sample of 1884 phy- sicians in Massachusetts by mail and assessed availabil- ity and use of EHR functions, predictors of use, and the relationships between EHR use and physicians’ percep- tions of medical practice. Results: A total of 1345 physicians responded to the sur- vey (71.4% response rate), and 387 (28.8%) reported that their practice had adopted EHRs. More than 80% of phy- sicians with EHRs reported having the ability to view labo- ratory reports (84.8%) and document visits electroni- cally (84.0%), but considerably fewer reported being able to order laboratory tests electronically (46.8%) or trans- mit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision support, transmittal of electronic pre- scriptions, and radiology order entry actually used these functions most or all of the time. Compared with phy- sicians 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 atti- tudes 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 func- tions available in EHRs and in the extent to which phy- sicians use them. Future work should emphasize fac- tors that affect the use of available functions.