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. 2013 Jun;20(e1):e33-8.
doi: 10.1136/amiajnl-2012-001609. Epub 2013 Mar 28.

Use of electronic medical records differs by specialty and office settings

Erik W J Kokkonen  1 , Scott A Davis, Hsien-Chang Lin, Tushar S Dabade, Steven R Feldman, Alan B Fleischer Jr
Affiliations

Use of electronic medical records differs by specialty and office settings

Erik W J Kokkonen et al. J Am Med Inform Assoc. 2013 Jun.

Abstract

Objective: To assess differences in the use of electronic medical records (EMRs) among medical specialties and practice settings.

Methods: A cross-sectional retrospective study using nationally representative data from the National Ambulatory Medical Care Survey for the period 2003-2010 was performed. Bivariate and multivariate analyzes compared EMR use among physicians of 14 specialties and assessed variation by practice setting. Differences in EMR use by geographic region, patient characteristics, and physician office settings were also assessed.

Results: Bivariate and multivariate analysis demonstrated increased EMR use from 2003 to 2010, with 16% reporting at least partial use in 2003, rising to 52% in 2010 (p<0.001). Cardiologists, orthopedic surgeons, urologists, and family/general practitioners had higher frequencies of EMR use whereas psychiatrists, ophthalmologists, and dermatologists had the lowest EMR use. Employed physicians had higher EMR uptake than physicians who owned their practice (48% vs 31%, p<0.001). EMR uptake was lower among solo practitioners (23%) than non-solo practitioners (42%, p<0.001). Practices owned by Health Maintenance Organizations had higher frequencies of EMR use (83%) than practices owned by physicians, community health centers, or academic centers (all <45%, p<0.001). Patient demographics did not affect EMR use (p>0.05).

Conclusions: Uptake of EMR is increasing, although it is significantly slower in dermatology, ophthalmology, and psychiatry. Solo practitioners and owners of a practice have low frequencies of EMR use compared with non-solo practitioners and those who do not own their practice. Despite incentives for EMR adoption, physicians should carefully weigh which, if any, EMR to adopt in their practices.

Keywords: EMR; NAMCS; technology.

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Figures

Figure 1
Figure 1
Proportion of ambulatory office visits from 2003 to 2010 among all specialties with use of electronic medical records (EMRs). Note that National Ambulatory Medical Care Survey data from 2003 to 2004 did not delineate full from partial EMR use.
Figure 2
Figure 2
Cumulative frequencies of electronic medical record (EMR) use among 14 different medical specialties from 2003 to 2010. Percentages represent unadjusted frequencies and represent both part and full EMR use combined. p<0.0001 for the difference between 2003 and 2010 frequencies in all specialties listed. The oncology stratum was not sampled in 2003.
Figure 3
Figure 3
Proportion of electronic medical record (EMR) use and proportion of solo practitioners by specialty type. Proportion of solo practitioners by specialty was determined by the number of physicians who reported being in solo practice to the National Ambulatory Medical Care Survey.
Figure 4
Figure 4
Proportion of electronic medical record (EMR) use by practice ownership.
See this image and copyright information in PMC

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