If electronic medical records are so great, why aren't family physicians using them? - Original Research

Journal of Family Practice, July, 2002 by Glenn A. Loomis, J. Scott Ries, Robert M. Saywell, Jr, Nitesh R. Thakker

TABLE 1
Demographic characteristics of respondents

                              User           Nonuser
Characteristic               n (%)            n (%)           P

  Female                   23 (26.1)        131 (25.0)       .925
  Mean age (y)           44.1 (8.84 SD)    44.6 (9.29 SD)    .059
  Mean number of         85.1 (51.4 SD)   116.1 (552 SD)    <.001
    outpatient visits
    per week
County type
  Rural                    26 (29.5)        194 (37.2)       .013
  Suburban                 28 (31.8)        204 (39.1)
  Urban                    34 (38.6)        124 (23.8)
Practice setting
  Solo                     12 (13.6)        101 (19.3)       .003
  Small FP (2-6)           21 (23.9)        191 (36.5)
  Large FP (>13)            8 (9.1)          55 (10.5)
  Multispecialty group      9 (10.2)         54 (10.3)
  Hospital employee        25 (28.4)         91 (17.4)
  Other                    13 (14.8)         31 (5.9)

89 users and 529 nonusers responded.

The number of users or nonusers for a given variable may be less
than the total due to missing responses.

FP, family practice; SD, standard deviation.
TABLE 2
Technology use by respondents

                             User      Nonuser
                            n (%)       n (%)      P

Computer use at home
  Computer                  89/89      507/527    .122
                           (100.0)     (96.2)
  Internet                  88/89      467/523    .007
                            (98.9)     (89.3)
  E-mail                    83/89      451/521    .111
                            (93.3)     (86.6)
Computer use at work
  Computer                  86/87      467/506    .043
                            (98.9)     (92.3)
  Internet                  78/88      318/506   <.001
                            (88.6)     (62.8)
  E-mail                    69/88      242/502   <.001
                            (78.4)     (48.2)
Computerized scheduling     83/89      420/526    .004
                            (93.3)     (79.8)
Computerized billing        79/84      458/489    .999
                            (94.0)     (93.7)
Handheld computer user      44/89      137/525   <.001
                            (49.4)     (26.1)

89 users and 529 nonusers responded. The number of users or nonusers
for a given variable be less than the total due to missing responses.
TABLE 3
Attitudes and beliefs regarding
electronic medical records

                                    Number (%) agreeing
                                       with statement

                                       User    Nonuser      P

Physicians should computerize         82/89    354/523    <.001
  their medical records               (92.1)   (67.7)
Currently available EMRs are          81/88    269/522    <.001
  a useful tool for physicians        (92.0)   (51.5)
EMRs will improve the quality         72/89    274/523    <.001
  of care in physicians' offices      (80.9)   (52.4)
Widespread use of EMRs                69/88    283/521    <.001
  would improve healthcare            (78.4)   (54.3)
  quality in the United States
EMRs will reduce my risk              70/89    297/525    <.001
  of making medical errors            (78.7)   (56.6)
I am interested in an EMIR            76/89    398/522     .076
  that would connect all              (85.4)   (76.2)
  physician practices, labs,
  x-ray facilities, and hospitals
  in my area securely for the
  exchange of patient data

89 users and 529 nonusers responded. The number of users or nonusers
for a given variable may be less than the total due to missing
responses.

EMR, electronic medical records.
TABLE 4
Possible barriers to electronic medical record use

                                          Number (%) agreeing
                                            with statement

                                                  User

Security and confidentiality
  EMRs are more secure                       48/88 (54.5)
  EMRs are more confidential                 55/88 (62.5)
  Object to sharing EMR data                 11/81 (13.6)
    with other physicians
Usefulness
  Easy to enter data                         49/89 (55.1)
  Ability to use an EMR with                 79/87 (90.8)
    minimal training
  Would like direct link to Medline          73/88 (83.0)
  Would like direct links to updated         73/87 (83.9)
    treatment guidelines
  Would like direct link to patient          83/88 (94.3)
    education materials
  EMR data should be available               46/89 (51.7)
    without patient or physician
    identifiers for use in clinical and
    health care services research
Costs
  Current EMRs are too costly                55/89 (61.8)
  Affordable price per physician
    to set up an EMR system
    <$1000                                    5/77 (6.5)
    $1000-$4999                              21/77 (27.3)
    $5000-$9999                              27/77 (35.1)
    $10,000-$19,999                          17/77 (22.1)
    >$20,000                                  7/77 (9.1)
Willing to spend monthly for
ongoing use of an EMR
  <$50                                           3 (3.9)
  $50-$99                                       23 (30.3)
  $100-$149                                     25 (32.9)
  $150-$199                                     14 (18.4)
  >$200                                         11 (14.5)

                                          Number (%) agreeing
                                             with statement

                                                Nonuser           P

Security and confidentiality
  EMRs are more secure                       111/523 (21.2)     <.001
  EMRs are more confidential                 115/524 (21.9)     <.001
  Object to sharing EMR data                 121/486 (24.9)      .037
    with other physicians
Usefulness
  Easy to enter data                         70/521  (13.4)     <.001
  Ability to use an EMR with                 479/522 (91.8)      .929
    minimal training
  Would like direct link to Medline          298/522 (57.1)     <.001
  Would like direct links to updated         360/521 (69.1)      .007
    treatment guidelines
  Would like direct link to patient          421/520 (81.0)      .003
    education materials
  EMR data should be available               263/521 (50.5)      .924
    without patient or physician
    identifiers for use in clinical and
    health care services research
Costs
  Current EMRs are too costly                355/522 (68.0)     <.001
  Affordable price per physician
    to set up an EMR system
    <$1000                                   65/464  (14.0)     <.001
    $1000-$4999                              202/464 (43.5)
    $5000-$9999                              147/464 (31.7)
    $10,000-$19,999                          42/464  (9.1)
    >$20,000                                  8/464  (1.7)
Willing to spend monthly for
ongoing use of an EMR
  <$50                                            89 (19.7)     <.013
  $50-$99                                        101 (22.4)
  $100-$149                                      139 (30.8)
  $150-$199                                       79 (17.5)
  >$200                                           43 (9.5)

89 users and 529 nonusers responded. The number of users or nonusers
for a given variable may be less than the total due to missing
responses. EMR, electronic medical records.