Adoption of health information technology varies significantly among physicians in different specialties, according to a new study from the Center for Studying Health System Change.
While only 12% of physicians overall have adopted comprehensive electronic medical records, physician uptake of specific health IT functions, such as obtaining guidelines or writing prescriptions, varies depending on specialty. For example, 74% of emergency physicians have health IT systems that can access patient notes, compared with just 36% of psychiatrists.
The findings are based on the Health System Change (HSC) 2004–2005 Community Tracking Study Physician Survey, a nationally representative telephone poll that included responses from 6,628 physicians.
As part of the survey, physicians were asked about practice-based availability of information technology across five clinical areas—obtaining information about treatment alternatives or recommended guidelines; retrieving patient notes or problem lists; writing prescriptions; exchanging clinical data and images with other physicians; and exchanging clinical data and images with hospitals.
Because physicians were asked about the availability of these health IT functions, not whether they actually used the technology, they were considered to have an electronic medical record if they answered that they had access to all five functions.
Surgeons trailed medical specialists in obtaining guidelines, accessing patient notes, writing prescriptions, and exchanging information with other physicians. Primary care physicians were less likely than specialists to access patient notes and exchange data with other physicians.
There were also variations across specialties and subspecialties. For example, within primary care, internists were more likely than family physicians or pediatricians to have access to patient notes. Among subspecialists, oncologists were more likely than other specialists to obtain guidelines, exchange information with other physicians, and exchange information with hospitals.
One factor in the variation among specialties may be that certain clinical activities are more relevant for certain specialties. "Surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis, in contrast to medical specialists and PCPs who treat chronically ill patients taking multiple medications," Catherine Corey, an HSC health research analyst and one of the study authors, said in a statement.
Another reason that some specialties may lag behind in adoption of health IT is that existing electronic products for keeping medical records may not meet their needs. For example, previous surveys have noted that most pediatricians without EMRs say they couldn't find one with functionality specific to pediatrics.
The full report is available at www.hschange.com/CONTENT/945/
