Technology usage climbs; EHR methods linked to quality of care

If you’re hooked on your technology-electronic health record (EHR) system, cell phone, and social media-you’re not alone. Two studies published online last week by the Journal of the American Medical Informatics Association found high usage rates among physicians, validating previous anecdotal evidence.

More surprisingly, the studies shed new light on the success rates of specific functions of your EHR and on the demographics of technology users.

The first study found that doctors who dictated their notes provided a lower quality of care to their patients with coronary artery disease and diabetes than those who hand-typed data into their EHR systems.

Specifically, dictators had “significantly worse” quality of care in three of 15 measured EHR categories: antiplatelet medication, tobacco use, and diabetic eye exam. Although variability existed between those who typed in structured documentation and those who typed in unstructured “free text” areas of their system, both forms of hand-typed data provided better outcomes than dictated data.

The good news: The vast majority of the nearly 250 doctors whose data were assessed-91%-favored typing notes, with more than half preferring free text typing. The 62% who used unstructured text performed worse than those using structured text on three measures (blood pressure, body mass index, and diabetic foot exam) and better on one (influenza vaccination).

The study, conducted by physicians at Boston’s Brigham and Women’s Hospital and Harvard Medical School, analyzed 7,000 patients over a 9-month period last year.

In the second study, conducted by researchers at the Centers for Disease Control and Prevention, nearly 81% of physicians surveyed used a portable device with Internet access, such as a smartphone or tablet.

That number topped data from 2011 that showed smartphone use hovering just under 70%, but it was less than a 2010 survey that put usage well above 94% .

The current study used data from a 2009 survey of more than 1,700 physicians across specialties. Using more recent data might have led to more pronounced changes in usage, study co-authors Crystale Purvis Cooper, PhD, and Cynthia A. Gelb say.

“At the same time, systematic changes may spawn new predictors of physician technology use or heighten the influence of those found in our study,” the authors tell Medical Economics exclusively. “For instance, increased use of student blogs as a training tool in medical schools could magnify the observed inverse relationship between blogging and years in practice.”

The study examined physician use of several technologies that had previously not been studied. Nearly 60% of respondents used social media, whereas almost 50% used email to connect with patients. In comparison, only 13% write blogs, and 19% use RSS feeds.

The majority of users were younger males with teaching hospital privileges. Specialty and practice setting were not shown to be indicators of mobile device usage. The study concluded that user demographics are likely to change as adoption rates increase and technologies change.

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