Table 3.
Percent of Providers Who Reported Item Was a Major or a Minor Concern in Using the EHR and Odds Ratios Adjusting for Provider Characteristics (N =400)*
| Length of time live on EHR (unadjusted percentages) | Adjusted models† | |||||
|---|---|---|---|---|---|---|
| EHR task | 6–12 months (N = 90) | 1–2 years (N = 129) | 2+ years (N = 181) | Overall | 1–2 years OR (95 % CI) | 2+ years OR (95 % CI) |
| Time constraints (to select, contract, and implement the EHR) | 51.8 % | 41.5 % | 37.4 % | 42.0 % | 0.66 (0.37,1.17) | 0.51 (0.29,0.88) |
| Financial costs (start-up or ongoing costs, not enough return on investment, or “ROI”)§ | 65.4 % | 47.9 % | 43.5 % | 49.7 % | 0.51 (0.27,0.94)‡ | 0.40 (0.22,0.72)§ |
| Loss of productivity during transition to the EHR system§ | 56.1 % | 46.2 % | 35.9 % | 43.7 % | 0.69 (0.39,1.23) | 0.46 (0.26,0.80)‡ |
| Lack of computer skills (your own, other providers, your staff) | 46.3 % | 43.2 % | 35.7 % | 40.5 % | 0.92 (0.52,1.64) | 0.66 (0.38,1.15) |
| Training issues (scheduling, time involved, staff turnover) | 61.0 % | 58.1 % | 51.8 % | 55.9 % | 0.88 (0.49,1.59) | 0.73 (0.42,1.27) |
| Unwillingness of other providers at the practice to use the technology | 24.4 % | 26.5 % | 21.2 % | 23.6 % | 1.07 (0.55,2.10) | 0.88 (0.46,1.68) |
| Not being able to rely on the EHR due to glitches/errors/crashing | 72.8 % | 61.5 % | 58.8 % | 62.8 % | 0.59 (0.32,1.09) | 0.54 (0.30,0.98)‡ |
| Vendor not responsive/poor technical support | 67.1 % | 59.0 % | 62.9 % | 62.6 % | 0.66 (0.36,1.21) | 0.81 (0.45,1.45) |
| Available EHR software does not meet the practice’s needs (e.g. not able to use the EHR with practice’s billing/claims submission system) | 37.4 % | 26.3 % | 27.1 % | 29.2 % | 0.58 (0.32,1.09) | 0.62 (0.34,1.10) |
| Privacy or security concerns‡ | 43.9 % | 30.5 % | 28.5 % | 32.6 % | 0.55 (0.30,1.01)‡ | 0.50 (0.28,0.89)‡ |
*“No longer a concern”, “not a concern”, and “don’t know” were counted as “not concerned”; “major concern” and “minor concern” counted as “concerned”
†Number of patient encounters, number of providers, specialty (Pediatrics), receipt of a medical degree between 2000 and 2009, owning the practice, workload of > 50 h, and English as first language are controlled for in the models; p values based on Chi-square statistic (unadjusted percentages) and logistic regression models. The reference group is being live on the EHR for 6–12 months
‡p < 0.05
§p < 0.001