Do provider attitudes about electronic health records predict future electronic health record use?

Prior research has shown that provider attitudes about EHRs are associated with successful adoption. There is no evidence on whether comfort with technology and more positive attitudes about EHRs affect use of EHR functions once they are adopted.

We used data from a survey of providers in the Primary Care Information Project, a bureau of the New York City Department of Health and Mental Hygiene and measures of use from their EHRs. The main predictor variables were scores on three indices: comfort with computers, positive attitudes about EHRs, and negative attitudes about EHRs. The main outcome measures were four measures of use of EHR functions. We used linear regression models to test the association between the three indices and measures of EHR use.

The mean comfort with computers score was 2.37 (SD0.53) on a scale of 1-3 with 3 being the most comfortable. The mean positive attitude score was 2.74 (SD 0.40) on a scale of 1-3 with 3 being more positive. The mean negative attitude score was 1.81 (SD 0.54) on a scale of 1-3 with 3 being more negative. Within the first twelve months of having the EHR, 59.5% of visits had allergy information entered into a structured field, 64.8% had medications reviewed, and 74.3% had blood pressured entered. Among visits with a prescription generated, 24.5% had prescriptions electronically. In multivariate regression analysis, we found no significant correlations between comfort with computers, positive attitudes about EHRs, or negative attitudes about EHRs and any of the measures of use.

Comfort with computers and attitudes about EHRs did not predict future use of the EHR functions. Our findings suggest that meaningful use of the EHR may not be affected by providers' prior attitudes about EHRs.