Appl Clin Inform 2013; 04(02): 225-240
DOI: 10.4338/ACI-2013-02-RA-0015
Resarch Article
Schattauer GmbH

Physician Specialty and Variations in Adoption of Electronic Health Records

Z. M. Grinspan
1  Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
2  Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY, USA
3  New York Presbyterian Hospital, New York, NY, USA
,
S. Banerjee
4  Department of Public Health, Weill Cornell Medical College, New York, NY, USA
,
R. Kaushal
1  Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
2  Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY, USA
3  New York Presbyterian Hospital, New York, NY, USA
4  Department of Public Health, Weill Cornell Medical College, New York, NY, USA
5  Health Information Technology Evaluation Collaborative, New York, NY, USA
,
L.M. Kern
2  Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY, USA
3  New York Presbyterian Hospital, New York, NY, USA
4  Department of Public Health, Weill Cornell Medical College, New York, NY, USA
5  Health Information Technology Evaluation Collaborative, New York, NY, USA
› Author Affiliations
Further Information

Correspondence to:

Zachary M Grinspan, MD
Helmsley Tower Room 605
1320 York Avenue
New York, NY 10128
Phone: 212–746–3278   
Fax: 917–210–3261

Publication History

received: 06 March 2013

accepted: 10 May 2013

Publication Date:
19 December 2017 (online)

 

Summary

Objective: Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored.

Methods: We conducted a retrospective cross-sectional study to determine the association between physician specialty and the prevalence of EHR adoption, and a retrospective serial cross-sectional study to determine the association of physician specialty and the rate of EHR adoption over time. We used the 2005–2009 National Ambulatory Medical Care Survey. We considered fourteen specialties, and four definitions of EHR adoption (any EHR, basic EHR, full EHR, and a novel definition of EHR sophistication). We used multivariable logistic regression, and adjusted for several covariates (geography, practice characteristics, revenue characteristics, physician degree).

Results: Physician specialty was significantly associated with EHR adoption, regardless of the EHR definition, after adjusting for covariates. Psychiatrists, dermatologists, pediatricians, ophthalmologists, and general surgeons were significantly less likely to adopt EHRs, compared to the reference group of family medicine / general practitioners. After adjustment for covariates, these specialties were 44 – 94% less likely to adopt EHRs than the reference group. EHR adoption increased in all specialties, by approximately 40% per year. The rate of EHR adoption over time did not significantly vary by specialty.

Conclusions: Although EHR adoption is increasing in all specialties, adoption varies widely by specialty. In order to insure each individual’s network of providers can electronically share data, widespread adoption of EHRs is needed across all specialties.

Citation: Grinspan ZM, Banerjee S, Kaushal R, Kern LM. Physician specialty and variations in adoption of electronic health records. Appl Clin Inf 2013; 4: 225–240

http://dx.doi.org/10.4338/ACI-2013-02-RA-0015


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Conflicts Of Interest

This project was supported in part by the National Institute for Neurologic Disease and Stroke grant #K12-NS0662. This project was also supported in part by funds from the Clinical Translational Science Center (CTSC), National Center for Advancing Translational Sciences (NCATS) grant #UL1-RR024996. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding source.


Correspondence to:

Zachary M Grinspan, MD
Helmsley Tower Room 605
1320 York Avenue
New York, NY 10128
Phone: 212–746–3278   
Fax: 917–210–3261