Do doctors act on their self-reported intention to computerize? A follow-up population-based survey in Hong Kong

We performed a follow-up survey to document changes in the level of computerization among physicians in Hong Kong between 2000 and 2001, specifically examining whether their self-reported intention to computerize various clinical or administrative tasks actually translated into computerization of these tasks 1 year later. Determining such a relationship will indicate the reliability, and thus the utility of questions regarding self-reported intention to computerize clinical practice.

A self-completed follow-up postal questionnaire was sent to all 949 physicians who responded to the original questionnaire. Pairwise repeated dichotomous responses from 2000 and 2001 on the computerization of specific functions were compared using McNemar test. Wilcoxon sign-ranked test was employed to compare the total number of tasks computerized in the 2 years. Multivariate logistic regression modeling was carried out to determine predictors for the translation of intention to computerize into actual computerization.

The response rate was 77.0%. There was a significant increase in the number of tasks computerized for both "corporate" and "individual" practices between 2000 and 2001. The proportion of physicians who intended to computerize and actually computerized ranged from 7.7 to 51.0% for different tasks. For five clinical tasks, more than 50% respondents in corporate practices translated the intention to implementation, compared to fewer than 20% in individual practices. Predictors found to be associated with the translation of intention to computerize into actual computerization included higher number of tasks intended to computerize, higher number of tasks already computerized, and more positive physicians' attitudes on the impact of computerization to clinical practice.

We conclude that physicians' self-reported intention to computerize the clinical practice 12 months previously was moderately associated with actual implementation, with varying degrees of concordance for different clinical and administrative tasks. The identified predictors for the translation of intention to actual computerization may be useful in targeting specific strategies to promote computerization of clinical practice.