The use of information technologies among rural and urban physicians in Florida

This study examines rural urban differences in the use of various information technologies (IT) applications by physicians in the ambulatory setting. Findings suggest that no differences exist between rural and urban physicians with respect to the use of a computer (77.4 vs 81.4; p=.144) or with the availability of an Internet connection (95.0 vs 96.5; p=.249) in the office. However, rural physicians were significantly less likely than urban doctors to indicate using e-mail with patients (7.9 vs 17.2%; p<.001) and slightly less likely to use a personal digital assistant (PDA) (32.3 vs 37.9; p=.091). Rural doctors were significantly less likely to indicate routinely using an electronic health records (EHR) system (17.6 vs 24.1; p=.020). EHR differences between rural and urban physicians were not significant (p=.124) in multivariate analyses and were explained away by practice size (p<.001) and practice type (p=.015). Most barriers to EHR did not differ between rural and urban physicians. However, rural physicians more commonly cited barriers associated with temporary disruptions to productivity or disruptions in access to records when computers systems fail. In sum, EHR use and patient e-mailing is less common in rural areas. While much of this variability can be explained by rural practice characteristics, these findings illustrate the need for further efforts to identify and alleviate barriers and encourage health IT adoption in rural areas.