Physicians and Electronic Health Records

Background: Electronic health records (EHRs) allow for a variety of functions, ranging from visit documen- tationtolaboratorytestordering,butlittleisknownabout physicians' actual use of these functions. Methods: We surveyed a random sample of 1884 phy- sicians in Massachusetts by mail and assessed availabil- ity and use of EHR functions, predictors of use, and the relationships between EHR use and physicians' percep- tions of medical practice. Results:Atotalof1345physiciansrespondedtothesur- vey(71.4%responserate),and387(28.8%)reportedthat their practice had adopted EHRs. More than 80% of phy- sicianswithEHRsreportedhavingtheabilitytoviewlabo- ratory reports (84.8%) and document visits electroni- cally(84.0%),butconsiderablyfewerreportedbeingable to order laboratory tests electronically (46.8%) or trans- mit prescriptions to a pharmacy electronically (44.7%). Fewer than half of the physicians who had systems with clinical decision support, transmittal of electronic pre- scriptions, and radiology order entry actually used these functions most or all of the time. Compared with phy- sicians who had not adopted EHRs, EHR users reported morepositiveviewsoftheeffectsofcomputersonhealth care; there were no significant differences in these atti- tudesbetweenhighandlowusersofEHRs.Overall,about 1 in 4 physicians reported dissatisfaction with medical practice; there was no difference in this measure by EHR adoption or use. Conclusions:Thereisconsiderablevariabilityinthefunc- tions available in EHRs and in the extent to which phy- sicians use them. Future work should emphasize fac- tors that affect the use of available functions.