Table 3.
Factors predicting use of health information technology functionalities, conditional on adoption of each functionality: results from linear regression models
| Problem list | Progress notes | Drug interactions | Prompts and reminders | Abnormal test results | Adopted all HIT† | Adopted any HIT† | ||
|---|---|---|---|---|---|---|---|---|
| Log size | −2.99*** (−5.23 to −0.76) | 3.24 (−0.74 to 7.21) | 3.66 (−0.91 to 8.23) | 11.39*** (5.66 to 17.13) | 13.16*** (5.91 to 20.41) | 6.06** (1.44 to 10.67) | 3.69** (0.43 to 6.96) | |
| More than one practice site | 3.08 (−5.97 to 12.13) | −4.10 (−16.66 to 8.47) | 0.94 (−4.81 to 6.70) | −7.80*** (−13.66 to −1.93) | −2.37 (−10.44 to 5.71) | −0.42 (−7.31 to 6.47) | 1.83 (−8.50 to 12.16) | |
| Hospital, system, or HMO ownership | 3.76** (0.23 to 7.28) | 2.10 (−4.01 to 8.21) | 11.42*** (5.21 to 17.62) | 12.41 (−17.61 to 42.43) | −1.31 (−12.80 to 10.18) | 7.86* (−1.40 to 17.13) | 2.80 (−1.08 to 6.68) | |
| Significant proportion of patients from an IPA or PHO | −5.32* (−11.24 to 0.60) | −4.79* (−10.06 to 0.47) | 114.15*** (−19.20 to −9.09) | −7.51* (−15.68 to 0.66) | 12.39* (−2.15 to 26.93) | −3.59*** (−5.81 to −1.37) | −1.79 (−8.71 to 5.12) | |
| Specialty mix (reference is primary care) | ||||||||
| Multispecialty practice type | −12.76** (−22.68 to −2.85) | −6.77 (−14.87 to 1.33) | −6.28 (−15.67 to 3.12) | −22.08*** (−30.61 to −13.56) | −13.56*** (−18.64 to −8.48) | −20.95*** (−36.65 to −5.24) | −12.87*** (−17.05 to −8.69) | |
| Single specialty practice type | −5.29* (−10.88 to 0.30) | 1.91 (−5.18 to 9.00) | −1.35 (−7.65 to 4.94) | −1.05 (−12.29 to 10.19) | −6.88 (−17.83 to 4.07) | −8.83*** (−15.47 to −2.19) | −3.51 (−8.67 to 1.65) | |
| Participated in QI program | 2.32 (−4.17 to 8.81) | 9.43 (−2.40 to 21.27) | −28.53** (−50.45 to −6.60) | 15.01* (−2.30 to 32.31) | 5.03 (−5.29 to 15.35) | 10.12 (−5.07 to 4.83) | 3.52 (−4.16 to 11.20) | |
| Patient-centered management index (range 0–5) | 1.01*** (0.33 to 1.69) | 1.42 (−4.01 to 6.85) | 3.61*** (2.27 to 4.94) | 8.35*** (3.92 to 12.78) | 2.74* (−0.05 to 5.52) | 3.75*** (1.86 to 5.63) | 3.24* (−0.46 to 6.93) | |
| Revenue from Medicaid or uninsured | 0.06 (−0.13 to 0.24) | 0.10 (−0.16 to 0.36) | −0.05 (−0.38 to 0.27) | 0.05 (−0.23 to 0.33) | 0.21 (−0.16 to 0.59) | 0.12 (−0.10 to 0.33) | 0.08 (−0.09 to 0.24) | |
| African-American patients | 0.07 (−0.07 to 0.22) | 0.23* (−0.01 to 0.47) | 0.04 (−0.36 to 0.43) | 0.28 (−0.13 to 0.68) | −0.09 (−0.31 to 0.12) | 0.05 (−0.19 to 0.29) | 0.14*** (0.04 to 0.25) | |
| Patients with limited English proficiency | −0.19 (−0.55 to 0.16) | −0.22 (−0.70 to 0.27) | 0.55* (−0.08 to 1.18) | −0.77*** (−1.34 to −0.20) | −0.32 (−1.01 to 0.37) | −0.36** (−0.70 to −0.02) | −0.08 (−0.34 to 0.17) | |
| Public reporting index (range 0–2) | −0.46 (−3.12 to 2.20) | 5.11** (0.25 to 9.96) | 6.06*** (4.36 to 7.75) | −0.77 (−8.79 to 7.25) | −7.82** (−14.45 to −1.18) | −0.50 (−2.78 to 1.79) | 0.14 (−3.22 to 3.50) | |
| Bonus income for HIT | 3.08 (−2.96 to 9.13) | −3.97 (−24.20 to 16.25) | 5.72** (0.40 to 11.04) | −2.22 (−15.03 to 10.60) | 8.43 (−3.63 to 20.49) | 3.96 (−2.25 to 10.17) | 0.75 (−9.59 to 11.09) | |
| Constant | 95.08*** (90.79 to 99.36) | 76.92*** (57.01 to 96.84) | 76.16*** (73.19 to 79.13) | 51.01*** (26.74 to 75.29) | 69.60*** (53.19 to 86.01) | 77.21*** (66.91 to 87.52) | 73.73*** (58.98 to 88.48) | |
| N | 576 | 551 | 451 | 387 | 379 | 240 | 626 | |
| R2 | 0.09 | 0.07 | 0.21 | 0.18 | 0.22 | 0.33 | 0.08 | |
*p<0.10; **p<0.05; ***p<0.01 .
†Because these models aggregate all five of the focal HIT functionalities, the dependent variable represents the average of the percent of physicians using each adopted function within each practice.
Ordinary Least Squares (OLS) regression analysis was used for all models. Results are presented as β coefficient (95% CI) and are weighted to be nationally representative.
Source: National Survey of Small and Medium-sized Physician Practices (July 2007–March 2009).
HIT, health information technology; HMO, health maintenance organization; IPA, independent practice association; PHO, physician–hospital organization; QI, quality improvement.