Electronic health record use-diffusion patterns and eSharing of health information among US office-based physician practices

Document Type

Article

Publication Date

9-1-2019

Abstract

Background: The use of some computerized capabilities (CCs) that support eligibility for meaningful use incentive has lagged despite an increase in Electronic Health Record adoption. Purpose: This study described the use-pattern of CC among office-based physician practices by applying the Use-Diffusion model (UD); to identify CCs that support the Stage 1 core objectives for meaningful use, and to predict their effect on eSharing of health information. Methods: Data from the United States 2013 National Ambulatory Medical Care Survey was used, and four use-patterns based on the variety and frequency of CC use were identified. Logistic regression was used to assess factors related to the use of a low variety of CC, and factors predictive of eSharing of health information. Results: The unweighted sample of 2444 physician practices reported at least one computerized capability. The unweighted proportion of each UD group was 53%, 20%, 15% and 12% representing the intense, non-specialized, specialized, and limited groups respectively. Only 5.3% in the specialized and 8.9% in the limited UD groups reported the ability to provide electronic access to patients in 2013. Provision of email/internet patient consult and having an increasing number of CCs were predictive of eSharing of health information. Conclusions: The use-diffusion model can describe office-based physician practices’ use-pattern of EHR capabilities, and the characteristics that differentiate the groups. Solo and specialty practices may lag in their readiness to meet the Stage 1 meaningful use objectives, both in the variety of capabilities and the frequency of use to qualify for incentive payments.

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