Older, Busier Clinicians More Likely to Adopt New Electronic Health Record Functionality

Electronic health records (EHRs) have been touted as a means of improving the quality of care in the United States. Conventional wisdom holds that younger physicians might be more likely to adopt EHR functionality. However, new research from Brigham and Women's Hospital (BWH) finds that contrary to conventional wisdom, older physicians who are clinically busier and see more complex patients were more likely to use novel EHR functionality than younger clinicians. This research is published online in advance of print in the Journal of the American Medical Informatics Association.

"It is important to understand the characteristics of clinicians who are either more or less likely to use newer EHR functionality.  This understanding could aid developers and health system leaders in more efficiently targeting design and implementation efforts," said Jeffrey Linder, MD, MPH, lead author of the paper and a  Primary Care physician-researcher at BWH.

Researchers analyzed the intervention arm of a randomized trial of new EHR-based tobacco treatment functionality. The trial included 207 clinicians and the functionality was used by 50 percent, or 103 clinicians. Of the clinicians who had access to the functionality, staff physicians were more likely than trainees to use it, clinicians who graduated more than 10 years previously were more likely to use it compared to those who graduated less than 10 years previously, and clinicians who had higher patient volumes were more likely to use the functionality compared to those with smaller volume. Additionally, clinicians who saw patients with a high rate of documented health issues were more likely to use the functionality when compared to clinicians whose patients had less complex health problems. 

"We were surprised to discover that the older physicians were likely to adopt and use new technology in the EHR," said Linder. "Avoiding assumptions about who will use new functionality will be important in ensuring an increase the use of these new functionalities and will contribute to the quality gains promised by the use of EHRs."

This study was supported by grants from the National Cancer Institute and the Agency for Healthcare Research and Quality.

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