EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption

Abstract

While adoption of electronic health record (EHR) systems has grown rapidly, little is known about physicians’ perspectives on its adoption and use. Nationally representative survey data from 2011 are used to compare the perspectives of physicians who have adopted EHRs with those that have yet to do so across three key areas: the impact of EHRs on clinical care, practice efficiency and operations; barriers to EHR adoption; and factors that influence physicians to adopt EHRs. Despite significant differences in perspectives between adopters and non-adopters, the majority of physicians perceive that EHR use yields overall clinical benefits, more efficient practices and financial benefits. Purchase cost and productivity loss are the greatest barriers to EHR adoption among both adopters and non-adopters; although non-adopters have significantly higher rates of reporting these as barriers. Financial incentives and penalties, technical assistance, and the capability for electronic health information exchange are factors with the greatest influence on EHR adoption among all physicians. However, a substantially higher proportion of non-adopters regard various national health IT policies, and in particular, financial incentives or penalties as a major influence in their decision to adopt an EHR system. Contrasting these perspectives provides a window into how national policies have shaped adoption thus far; and how these policies may shape adoption in the near future.

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

“…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.…”

“…Another objective of our study was to investigate the effect of physicians' attitude towards health IT on health IT adoption, use of electronic workflow practices and the intention to expand individual health IT use in the future, because a lot of qualitative studies suggested that there exists an association [5,14,16,29,[31][32][33][34][35][36]. Indeed, it emerged that physicians' attitude towards health IT was an independent predictor on most outcomes (Table 4).…”

“…We designed the respective items according to literature indicating that the concepts underlying these items reflect important motivational forces (e.g. healthcare providers' (dis-)satisfaction with the status quo, perceived ease of use, perceived usefulness) and socio-technical factors that can facilitate or limit the adoption of health IT in healthcare professionals [5,14,16,29,[31][32][33][34][35][36][37][38][39]. …”

“…This led policy makers to base national eHealth strategies largely on measures to accelerate the adoption of EHR systems [8][9][10][11]. Especially studies on barriers to the acceptance of eHealth and frameworks for the assessment of eHealth readiness tend to focus particularly on healthcare providers' views of EHRs [7,[12][13][14][15][16]. The problem is, however, that this approach neglects the great variety of EHR definitions and potentially available EHR functionalities.…”

Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings

“…27 We need to continue to track and understand the factors holding nonadopters back so that the next generation of policies can be designed to result in universal use of EHR systems.…”