Study: Ambulatory Care Practices Underuse Health Information Technology

Ambulatory care practices are not utilizing many functions available with health information technology (IT), according to new AHRQ-funded research. The study, published in The American Journal of Managed Care and based on 2014 Health Information and Management Systems Society (HIMSS) Analytics survey data, was developed to measure the levels of implementation and use of health IT among ambulatory care practices. Researchers found that as of 2014, 73 percent of practices were not using electronic health record (EHR) technologies to their full capability. Nearly 40 percent of the surveyed practices made minimal or no use of health IT. Researchers said that underuse of health IT in ambulatory care could affect a health system’s ability to provide coordinated and efficient care. The authors concluded that efforts to increase the use of health IT functionalities should focus on practices that are small, located in nonmetropolitan areas and provide specialty care. Access the abstract.

2018 Jan;24(1):26-31.

Electronic health record "super-users" and "under-users" in ambulatory care practices.

Rumball-Smith J1, Shekelle P, Damberg CL.

Author information

Abstract

OBJECTIVES:

This study explored variation in the extent of use of electronic health record (EHR)-based health information technology (IT) functionalities across US ambulatory care practices. Use of health IT functionalities in ambulatory care is important for delivering high-quality care, including that provided in coordination with multiple practitioners.

STUDY DESIGN:

We used data from the 2014 Healthcare Information and Management Systems Society Analytics survey. The responses of 30,123 ambulatory practices with an operational EHR were analyzed to examine the extent of use of EHR-based health IT functionalities for each practice.

METHODS:

We created a novel framework for classifying ambulatory care practices employing 7 domains of health IT functionality. Drawing from the survey responses, we created a composite "use" variable indicating the extent of health IT functionality use across these domains. "Super-user" practices were defined as having near-full employment of the 7 domains of health IT functionalities and "under-users" as those with minimal or no use of health IT functionalities. We used multivariable logistic regression to investigate how the odds of super-use and under-use varied by practice size, type, urban or rural location, and geographic region.

RESULTS:

Seventy-three percent of practices were not using EHR technologies to their full capability, and nearly 40% were classified as under-users. Under-user practices were more likely to be of smaller size, situated in the West, and located outside a metropolitan area.

CONCLUSIONS:

To achieve the broader benefits of the EHR and health IT, health systems and policy makers need to identify and address barriers to full use of health IT functionalities.