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Undirected health IT implementation in ambulatory care favors paper-based workarounds and limits health data exchange.
- Source :
-
International journal of medical informatics [Int J Med Inform] 2015 Nov; Vol. 84 (11), pp. 920-32. Date of Electronic Publication: 2015 Aug 04. - Publication Year :
- 2015
-
Abstract
- Background: The adoption and use of health information technology (IT) continues to grow around the globe. In Switzerland, the government nor professional associations have to this day provided incentives for health IT adoption.<br />Objective: We aim to assess the proportion of physicians who are routinely working with electronic health data and describe to what extent physicians exchange electronic health data with peers and other health care providers. Additionally, we aim to estimate the effect of physicians' attitude towards health IT on the adoption of electronic workflows.<br />Methods: Between May and July 2013, we conducted a cross-sectional survey of 1200 practice based physicians in Switzerland. Respondents were asked to report on their technical means and where applicable their paper-based workarounds to process laboratory data, examination results, referral letters and physician's letters. Physicians' view of barriers and facilitators towards health IT use was determined by a composite score.<br />Results: A response rate of 57.1% (n=685) was reached. The sample was considered to be representative for physicians in Swiss ambulatory care. 35.2% of the respondents documented patients' health status with the help of a longitudinal semi-structured electronic text record generated by one or more encounters in the practice. Depending on the task within a workflow, around 11-46% of the respondents stated to rely on electronic workflow practices to process laboratory and examination data and dispatch referral notes and physician's letters. The permanent use of electronic workflow processes was infrequent. Instead, respondents reported paper-based workarounds affecting specific tasks within a workflow. Physicians' attitude towards health IT was significantly associated with the adoption of electronic workflows (OR 1.04-1.31, p<0.05), but the effect sizes of factors related to the working environment (e.g., regional factors, medical specialty, type of practice) were larger.<br />Conclusion: At present, only a few physicians in Swiss ambulatory care routinely work with electronic health data. Until more of their peers participate in electronic exchange of structured clinical information, most physicians will continue to stay in paper-based systems and workarounds. The survey found that physicians with a positive attitude towards health IT were more likely to adopt electronic workflows, but the impact is minor. It will likely be necessary to introduce financial incentives and develop national standards in order to promote the adoption by a critical mass of practicing clinicians.<br /> (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Adult
Age Distribution
Aged
Ambulatory Care
Cross-Sectional Studies
Female
Health Information Exchange
Humans
Logistic Models
Male
Medical Informatics statistics & numerical data
Middle Aged
Practice Patterns, Physicians' statistics & numerical data
Referral and Consultation
Sex Distribution
Surveys and Questionnaires
Switzerland
Workflow
Attitude of Health Personnel
Attitude to Computers
Electronic Health Records statistics & numerical data
Medical Informatics methods
Physicians psychology
Physicians statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1872-8243
- Volume :
- 84
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- International journal of medical informatics
- Publication Type :
- Academic Journal
- Accession number :
- 26296433
- Full Text :
- https://doi.org/10.1016/j.ijmedinf.2015.08.001