Many functions important to realizing the full potential from electronic health records (EHRs) may not be selected by all physicians using EHRs in the ambulatory setting. This article examines the extent to which EHR systems used by Florida physicians include functionalities that the Institute of Medicine has designated as being critical for optimal performance. Results indicate that EHR systems used by recent adopters, when compared with early adopters, appear to be missing key patient safety and cost control functions. Overall, many physicians are only partially adopting EHR technologies, suggesting that published adoption rates may be exaggerating the true rate of diffusion. (Am J Med Qual 2007;22:319-326)
Cooper J.Organization, management, implementation and value of EHR implementation in a solo pediatric practice. J Healthc Inf Manage.2004;18(3):51-55.
2.
Erstad T.Analyzing computer based patient records: a review of literature. J Healthc Inf Manage.2003;17(4):51-57.
3.
Menachemi N. , Brooks RGReviewing the benefits of electronic health records and associated patient safety technologies. J Med Syst.2006;30:159-168.
4.
Wang SJ, Middleton B., Prosser LA, et al. A cost-benefit analysis of electronic medical records in primary care. Am J Med.2003;114:397-403.
5.
Bush GWExecutive order. Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator . Code of Federal Regulations;2004.
6.
Powner DAHealth information technology: HHS is continuing efforts to define its national strategy. In: Issues ITM. Washington, DC : Government Printing Office; 2006 .
7.
Robeznieks A.AHIC is told EHR adoption rates are a matter of definition. Modern Healthcare. 2006;36(30). Available at: http://modernhealthcare.com/apps/pbcs.dll/article?AID=/20060726/PREMIUM/607260315&SearchID=73282639411720 .
8.
Ford EW, Menachemi N., Phillips MTPredicting the adoption of electronic health records by physicians: when will health care be paperless?J Am Med Inform Assoc. 2006;13: 106-112.
9.
Jha AK, Ferris TG, Donelan K., et al. How common are electronic health records in the Unites States? A summary of the evidence. Health Aff (Millwood). 2006;w496-w507. Available at: http://content.healthaffairs.org/cgi/content/abstract/25/6/w496?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=jha&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT . Accessed November 15, 2006.
10.
Audet AM, Doty MM, Peugh J., Shamasdin J., Zapert K., Schoenbaum S.Information technologies: when will they make it into physicians' black bags? Medsc GenMed.2004; 6(4):2.
11.
Miller RH, Hillman JM, Given RSPhysician use of IT: results from the Deloitte Research Survey. J Healthc Inf Manage. 2004;18(1):72-80.
12.
Gans D., Kralewski J., Hammons T., Dowd B.Medical groups' adoption of electronic health records and information systems . Health Aff (Millwood).2005;24:1323-1333.
13.
Simon JS, Rundall TG, Shortell SMDrivers of electronic medical record adoption among medical groups. Jt Comm J Qual Patient Saf.2005;31:631-639.
14.
Baron RJ, Fabens EL, Schiffman M., Wolf E.Electronic health records: just around the corner? Or over the cliff?Ann Intern Med.2005;143:222-226.
15.
Davis FD, Bagozzi RP, Warshaw PRUser acceptance of computer technology: a comparison of two theoretical models . Manage Sci.1989;35:982.
16.
Davis FDPerceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly. 1989;13:319-339.
17.
Klopping IM , McKinney E.Extending the Technology Acceptance Model and the Task-Technology Fit Model to consumer e-commerce. Inform Technol Learn Perform J. 2004;22(1):35.
18.
Menachemi N. , Brooks RGEHR and other IT adoption among physicians: results of a large-scale statewide analysis. J Healthc Inf Manage.2006;20(3):79-87.
19.
Rogers EMDiffusion of Innovations. New York, NY: Free Press of Glencoe; 1962.
20.
Gladwell M.The Tipping Point: How Little Things Can Make a Big Difference. Boston, MA: Little Brown; 2000.
21.
Brailer DJEHRs: the Fed's big push. Med Econ.2004; 81(16):26, 28-29.
22.
Sroufe R., Curkovic S., Montabon F., Melnyk SAThe new product design process and design for environment “Crossing the chasm.” Int J Oper Prod Manage. 2000;20:267.
23.
Ling S-S., Pysarchik DT, Choo HJAdopters of new food products in India. Market Intell Plan. 2004;22:371.
24.
Moore GACrossing the Chasm: Marketing and Selling High-Tech Products to Mainstream Customers. New York, NY: Harper Business; 1991.
25.
Aspden P, Corrigan JM, Wolcott J, Erickson SM, eds. Patient Safety: Achieving a New Standard For Care. Washington, DC: The National Academies Press; 2004.
26.
Menachemi N. , Hikmet N., Stutzman M., Brooks R.Investigating response bias in a health information technology survey of physicians. J Med Syst.2006;30:277-282.
27.
Menachemi N. , Ettel DL, Brooks RG, Simpson L.Charting the use of electronic health records and other information technologies among child health providers. BMC Pediatr. 2006;6(1):21.
28.
Rogers E.Diffusion of Innovations. 4th ed. New York, NY: Free Press; 1995.
29.
Pasko T., Smart D.Physician Characteristics and Distribution in the US. Chicago, IL: American Medical Association; 2004.
30.
Papshev D., Peterson AMElectronic prescribing in ambulatory practice: promises, pitfalls, and potential solutions. Am J Manag Care.2001;7:725-736.
31.
Bell DS, Cretin S., Marken RS, Landman ABA conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities. J Am Med Inform Assoc . 2004;11:60-70.
32.
Johnston D. , Pan E., Walker J.The value of CPOE in ambulatory settings. J Healthc Inf Manage. 2004;18(1):5-8.
33.
Kaushal R., Shojania KG, Bates DWEffects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med.2003;163:1409-1416.
34.
Bobb A., Gleason K., Husch M., Feinglass J., Yarnold PR, Noskin GAThe epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Arch Intern Med.2004 ;164:785-792.
35.
Gurwitz JH, Field TS, Harrold LR, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA.2003 ;289:1107-1116.
36.
Munoz S.Rx by e-mail may save $29 billion: a national system to end handwritten prescriptions can reduce costly errors. Wall Street Journal. April 15, 2004:D7.
37.
Weise E.Study: Medication errors harm 1.5M a year. USA Today. July 21, 2006;Money section:3B.
38.
Kritz F. Bye-bye , paper Rx?Washington Post. July 1, 2003;Health section:F1.
39.
Eger MS, Godkin RL, Valentine SRPhysicians' adoption of information technology: a consumer behavior approach . Health Mark Q. 2001;19(2):3-21.
40.
Dansky KH, Gamm LD, Vasey JJ, Barsukiewicz CKElectronic medical records: are physicians ready?J Healthc Manage. 1999;44:440-454.
