Interactive Effects of Health Care Market Characteristics on the Relationship between Physicians' Perception and Use of Information Technology

Background: Physician use of information technology (IT) for health care varies across communities. We examined whether the relationship between physicians' perception of IT and use of IT is affected by health care market characteristics.

Study Design: Two scores, based on seven items from the 2000-2001 Community Tracking Study Physician Survey (CTS-PS), measured IT use for information searching and communication and IT use for direct patient care. Physician perception of IT effectiveness for these purposes was captured based on 1998-1999 CTS-PS. Health care market characteristics included HMO penetration rate and physician-perceived market competition. Physician demographic characteristics, practice type, and organizational environment were control variables. Multi-level analysis was used to examine the cross-level interaction effect of market characteristics on the relationships between perception of IT effectiveness and IT use. The sample of 7,429 physicians was used.

Results: In multilevel analysis, perceived market competition was found to reduce the slope of the relationship between perception and use of IT for information searching and communication (â= -0.1175; p=0.0244). Thus, in high competition markets the slope is reduced, while in low competition markets, it is increased. Health care market characteristics did not alter the perception-use relationship for direct patient care.

Conclusion: Physicians' perception of IT effectiveness for data communication strongly affects their use of IT this purpose. Efforts to increase physician use of IT for searching and communication are more likely to be successful when physicians do not perceive high local competition.