Predictors of physician use of a health information technology application

Background: Multiple stakeholders have proposed developing mechanisms to share administrative data with patients and clinicians to support quality improvement and clinical decision-making in healthcare settings. However, the potential of such systems will be limited by its adoption in clinical practice. Objective: Understanding physician- and hospital-level factors associated with use can inform development and implementation strategies for health information technologies. Methods: A total of 367 psychiatrists in 19 New York State psychiatric hospitals were given access to PSYCKES, software that provides access to state utilization and pharmacy data. Physician and facility characteristics were examined relative to patterns of PSYCKES use over time. Given the interdependence of physicians within facilities, generalized linear multi-level modeling was used. Results: PSYCKES use stabilized within three months of training. Supervising psychiatrists had 2.4 (95% CI: 1.3-4.5) greater odds of being a consistent PSYCKES user when compared to attending psychiatrists. Physicians who attended training had 2.3 (95% CI: 1.4-3.5) greater odds of being a consistent user than those who did not. Facility-level effects showed that PSYCKES use was significantly greater in facilities with very supportive executive leadership, as compared to facilities where leadership was marginally or not at all interested in PSYCKES implementation (OR: 3.1, 95% CI: 1.4-7.2). Discussion: Physician use of a health informatics system was heavily dependent on user role, training, and facility leadership interest in the technology. Implications for future implementations include need for leadership and supervisory engagement.