Older, busier clinicians who see complex patients are more likely to use novel electronic health record (EHR) functions
Research Activities, May 2012, No. 381
A growing number of clinical settings are adopting electronic health record (EHR) systems. EHR systems that include clinical decision support (CDS) functionality have shown potential for improving care quality. While most people might assume that older, busier, and established physicians are less likely to fully embrace EHRs, a new study finds that busy physicians who see patients with complex needs are more willing to use novel functions of EHRs.
In this study, physicians were introduced to a three-part EHR enhancement focused on tobacco use and treatment. The enhancement included providing clinicians with (1) smoking status icons, (2) tobacco treatment reminders, and (3) a Tobacco Smart Form to be used to facilitate medication ordering and counseling referrals. Twelve of the 26 primary care practices participating in the study were randomly assigned to receive this enhancement. Even though only 103 of the 207 clinicians in the intervention practices used the functionality, study results show an increase in the documentation of patient tobacco use. In addition, more contacts were made between smokers and tobacco counseling.
When reviewing how often the enhancement was used and by whom, study researchers found that, during the study period, 90 clinicians (43 percent) used the Smart Form one or more times. The functionality was used by 74 clinicians (36 percent) to refer at least one patient to a counselor for tobacco treatment. Staff physicians were more likely than trainees to use the functionality. Users were also more likely to be in practice longer (10 to 30 years) and be busier seeing patients with more problems compared to non-users. In fact, these busier staff clinicians were more likely to be heavy users. According to the researchers, such physicians may see the time-saving potential in novel EHR functionality and be more inclined to want to obtain the benefits for their practices. The study was supported in part by the Agency for Healthcare Research and Quality (HS15169).
See "Clinician characteristics and use of novel electronic health record functionality in primary care," by Jeffrey A. Linder, M.D., M.P.H., Nancy A. Rigotti, M.D., Louis I. Schneider, M.D., and others in the December 2011 Journal of the American Medical Informatics Association 18(Suppl 1), pp. i87-i90.