IT for patient care varies widely across U.S. physician practices

While there's wide enthusiasm for harnessing the power of information technology (IT) to improve U.S. medical care, fewer than a quarter of physicians in 2001 could generate electronic treatment reminders for use during patient visits and only about 10 percent could write electronic prescriptions, according to a national study released today by the Center for Studying Health System Change (HSC).

Providing the first nationally representative snapshot of the availability of information technology to support patient care in physician offices across specialties, practice settings and geographic areas, the study found wide variation in IT adoption across physician practices. The study examined whether physician practices used computers or other information technology for the following five clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing patient notes, generating treatment reminders for the physician's use and writing prescriptions.

Nearly 60 percent of physicians in traditional practice settings—primarily solo or relatively small group practices where the vast majority of Americans receive care—reported that their practice used information technology for no more than one of the five clinical functions.

Highest levels of IT support for patient care were found in staff- and group-model health maintenance organization (HMO) practices, followed by medical school faculty practices and large group practices. Overall rates of information technology adoption may have increased since 2001, but the variation in IT adoption by practice setting is unlikely to have changed, the study concluded

"The promise of information technology to improve patient care remains just that—a promise—in most physician practices across the country," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded primarily by The Robert Wood Johnson Foundation.

The study found significant variation in the availability of information technology across practice settings. The almost 70 percent of physicians in traditional practice settings-solo, small groups with up to 50 physicians or practices owned by hospitals-were least likely to be in practices using information technology, with IT adoption rates ranging between 8 percent and 50 percent for the five functions examined.

"The study provides a benchmark of IT adoption among physicians that can help policy makers target efforts to spur the use of information technology to improve patient care," said HSC Health Research Analyst Marie Reed, M.H.S, who co-authored the study with Joy M. Grossman, Ph.D., HSC associate director.

The study's findings are detailed in an HSC Issue Brief—Limited Information Technology for Patient Care in Physician Offices. The study is based on results from HSC's 2001 Community Tracking Study Physician Survey, a nationally representative survey involving about 12,000 practicing physicians.

While practice setting, especially size, was clearly the most important factor in IT adoption, other factors, such as physician age, specialty, and whether the practice was in an urban or rural area, played relatively minor roles as underlying drivers of IT adoption.

Although differences between urban and rural areas were not large, there was considerable variation in the availability of IT across the 12 metropolitan communities. For example, more than 60 percent of physicians in three markets—Phoenix; Lansing, Mich.; and northern New Jersey—had limited access to IT support for patient care compared with less than 45 percent in Boston; Little Rock, Ark.; and Seattle. These market differences remained after accounting for factors such as practice setting and physician age and specialty, suggesting other factors are driving variation across communities.