When does adoption of health information technology by physician practices lead to use by physicians within the practice?
OBJECTIVE
We sought to determine the extent to which adoption of health information technology (HIT) by physician practices may differ from the extent of use by individual physicians, and to examine factors associated with adoption and use.


MATERIALS AND METHODS
Using cross-sectional survey data from the National Study of Small and Medium-Sized Physician Practices (July 2007-March 2009), we examined the extent to which organizational capabilities and external incentives were associated with the adoption of five key HIT functionalities by physician practices and with use of those functionalities by individual physicians.


RESULTS
The rate of physician practices adopting any of the five HIT functionalities was 34.1%. When practices adopted HIT functionalities, on average, about one in seven physicians did not use those functionalities. One physician in five did not use prompts and reminders following adoption by their practice. After controlling for other factors, both adoption of HIT by practices and use of HIT by individual physicians were higher in primary care practices and larger practices. Practices reporting an emphasis on patient-centered management were not more likely than others to adopt, but their physicians were more likely to use HIT.


DISCUSSION
Larger practices were most likely to have adopted HIT, but other factors, including specialty mix and self-reported patient-centered management, had a stronger influence on the use of HIT once adopted.


CONCLUSIONS
Adoption of HIT by practices does not mean that physicians will use the HIT.
['McClellan|Sean R|SR|', 'Casalino|Lawrence P|LP|', 'Shortell|Stephen M|SM|', 'Rittenhouse|Diane R|DR|']
D006801:Humans D016014:Linear Models D008490:Medical Informatics D016347:Medical Records Systems, Computerized D010818:Practice Patterns, Physicians' D014481:United States
Physician practices electronic health records meaningful use