Readiness for electronic health records: comparison of characteristics of practices in a collaborative with the remainder of Massachusetts

Abstract

Objective The Massachusetts e-Health Collaborative (MAeHC) is implementing electronic health records (EHRs) in physicians' offices throughout three diverse communities. This study's objective was to assess the degree to which these practices are representative of physicians' practices statewide. Design We surveyed all MAeHC physicians (n=464) and compared their responses to those of a contemporaneously surveyed statewide random sample (n=1884). Measurements The survey questionnaire assessed practice characteristics related to EHR adoption, prevailing office culture related to quality and safety, attitudes toward health information technology (HIT) and perceptions of medical practice. Results A total of 355 MAeHC physicians (77%) and 1345 physicians from the statewide sample (71%) completed the survey. MAeHC practices resembled practices throughout Massachusetts in terms of practice size, physician age and gender, prevailing financial incentives for quality performance and HIT adoption and available resources for practice expansion. MAeHC practices were more likely to be located in rural areas (9.5% vs 4.4%, P=0.004). Physicians in both samples responded similarly to six of seven self-assessments of the office practice environment for quality and safety. Internet connections were more prevalent among MAeHC practices than across the state (96% vs 83%, P<0.001), but similar proportions of MAeHC physicians (83%) and statewide physicians (86%) used the internet daily (P=0.19). Conclusion MAeHC is implementing EHRs and health information exchange among communities

Systematic Review of Health Information Exchange in Primary Care Practices

“…Simon et al (19) Research (qualitative) Cross-sectional comparisons of physicians in the Massachusetts e-health collaborative (n ϭ 355) and others randomly selected in the state (n ϭ 794). Benefits: physicians in the HIE demonstration site were more likely to report positive effects from health IT and were more likely to expect health IT to control costs.…”

“…18,19,34,[45][46][47] However, much of the evidence for actual improvements in quality and safety is self-reported from small numbers of HIEs. In the 2008 eHealth Initiative survey, 6 of 42 HIEs (14%) reported better care outcomes for patients, 5 (12%) documented reduced patient admissions, and 4 (9.5%) reported decreased prescribing errors.…”

“…19 HIE facilitates the transfer of quality measures that can result in physician compensation in the form of pay-for-performance incentives. 19 Legislative mandates are also potent motivators. 34 …”

Massachusetts E-Health Project Increased Physicians’ Ability To Use Registries, And Signals Progress Toward Better Care

“…The characteristics of these communities and the physicians and practices within them reflected the demographics and practice characteristics of physicians and practices across Massachusetts. 8,14 A total of 167 physician practices participated, representing 86 percent of all eligible primary care and specialty practices in these communities. All were invited to respond to pre-intervention (2005) Survey Design The pre-and post-intervention surveys were based on similar statewide surveys of physicians, described elsewhere.…”

“…All were invited to respond to pre-intervention (2005) Survey Design The pre-and post-intervention surveys were based on similar statewide surveys of physicians, described elsewhere. 11,14,[16][17][18] Briefly, the 2005 survey measured physicians' attitudes toward the use of computers in health care and specifically assessed the ability of each practice to generate registries. The postintervention (2009) survey retained the original survey items and added new questions related to health information exchange and the electronic health record implementation process.…”