Physicians Slow to Adopt Technology for Patient Care

Older physicians (55 years and older) were less likely than younger physicians to have IT support in their practices for all clinical functions.

The adoption of information technology (IT) to support patient care functions varies widely across physician practices, according to findings from a study conducted by the Center for Studying Health System Change (HSC). The most significant factor associated with more rapid adoption of IT was a larger physician practice. Overall, IT adoption by physicians continues to move at a slow pace despite IT having been identified by the Institute of Medicine as playing a pivotal role in systematically improving the quality of clinical care and reducing health care costs.

HSC’s Community Tracking Study Physician Survey of 12,400 physicians conducted in 2001 provides nationally representative data on the availability of IT in physicians’ offices across specialties, practice settings, and geographic areas. In the survey, physicians were asked whether computers or other forms of IT were used in their practice to support 5 clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing notes on individual patients, generating treatment reminders for the physician’s use, and writing prescriptions.

The vast majority of patients were treated in physician practices lacking significant IT support for patient care in 2001. One quarter of all physicians were in practices with no computer or other form of IT support for any of the 5 functions, and another quarter had IT available for just 1 function. Only about 1 in 10 physicians were in practices with IT support for 4 or 5 functions.
Adoption of IT varied considerably by function. IT was most often used to obtain information on treatment guidelines (53%), while electronic prescribing was least likely (11%) to be available in physicians’ offices.

There was significant variation in the availability of IT across practice settings. The nearly 70% of physicians in traditional settings (solo, groups with up to 50 physicians, or practices owned by hospitals) were least likely to be in practices that used IT, with IT adoption rates ranging from 8% to 50% for the 5 functions examined. For most functions, physicians in groups of more than 50 physicians (3% of study sample) and medical school faculty practices (8%) were about 50% more likely than physicians in traditional practice settings to report IT availability for the 5 patient-support functions. Physicians in staff or group model HMOs (4% of survey sample) were more than twice as likely as those in traditional settings to have IT support for patient care.

Rates of IT adoption for selected functions differed between primary care physicians and specialists and by physician age, although these differences were less than the variations seen for practice size. Primary care physicians reported higher rates of adoption of technology to generate treatment reminders and prescribe electronically, while specialists had higher rates of technology use to exchange clinical data and access patient notes. Older physicians (55 years and older) were less likely than younger physicians to have IT support in their practices for all clinical functions except generating treatment reminders.

There was considerable geographic variation among randomly selected metropolitan areas surveyed.

HSC Community Tracking Study Physician Survey, Center for Studying Health System Change.

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