Factors Impacting Use of Information Technology by Physicians in Private Practice

Introduction

Heath information technology (HIT) has been identified as a necessary tool in the battle to improve the efficiency, quality and delivery of health care in the United States (Payton, Pare, LeRouge, & Reddy, 2011). In spite of the explosion of applications of information technology at work in various sectors of the US economy, it is rather surprising that healthcare remains one of the few industries which still rely heavily on paper records (Gates & Roeder, 2011). Through the Office of the National Coordinator for Health Information Technology (ONC), the federal government has been actively pushing for the rapid transition of healthcare information and communication into the 21^st century. The potential for quality, accuracy, and cost improvements is tremendous and preliminary studies show that many benefits like improvements in accuracy, quality, and efficiency can accrue to different stakeholders like institutions, patients, and providers (Blumenthal, 2010; Goldzweig, Towfigh, Maglione, & Shekelle, 2009).

Unfortunately, in spite of the overwhelming evidence regarding the positive effects of HIT innovations like electronic health records (EHR) on the quality and efficiency of health care, there is still considerable skepticism about adopting the technology among health care providers, especially those in private practice settings (Buntin, Burke, Hoaglin, & Blumenthal, 2011). In fact, a recent report indicated that although the USA spends around $2 trillion per year on healthcare (16% of GDP, $6697 per capita) only about 15% of its physicians use EHRs to manage patients’ health information. This compares with a roughly 29% utilization rate by physicians in the European Union (Maharajah & McIntyre, 2010). Since 2009, the Obama Administration has made an unprecedented attempt to promote the adoption of EHRs and spur the development of further innovations in health care delivery systems. This includes passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act into law in 2009 (as part of the American Recovery and Reinvestment Act), the commitment of approximately $27 billion as incentive payments to hospitals and care providers, and the establishment of various programs and centers to promote, coordinate, and supervise the development and implementation of innovative payment, health care delivery models, and health information systems in the United States (Buntin et al., 2011).

Preliminary reviews on the effects of health information technology innovations have revealed positive benefits, especially for larger organizations that were early adopters of the technology (DesRoches, Campbell, Rao, Donelan, Ferris, & Jha, 2008; Jha, DesRoches, Campbell, Donelan, Rao, & Ferris, 2009). However, there have been significant negative reactions from health care providers regarding the start-up costs and loss of patient contact time that would result as a consequence of adopting the technology (Bates, 2005; Georgiou, Westbrook, Braithwaite, Idema, & Ray, 2007; Georgiou & Westbrook, 2009). These kinds of reactions have resulted in a significantly slower than anticipated rate of adoption of the Health IT systems by some types of health care providers.