How the changes in IT use in Physicians are related to physician compensation and market factor?

(1) Background

Since 2000, information technologies have been increasingly adopted but it is not necessarily related to higher use of IT for patient care by physicians.

(2) Objective

1) To see changes in physicians' use of IT for clinical activities between 2000 and 2004; 2) to see physician compensation and market situations are related to increased use of IT for the clinically related activities.

(3) Methods

Two series of physician surveys were combined (2000-01 and 2004-05 CTS physician survey) and total of 4,428 physicians were captured in the panel. Four IT use for clinical activities were selected (generate reminders, access patient notes, write prescriptions, clinical data exchange). Three physician compensation variables (productivity, quality of care, patient satisfaction); and Market variables (revenue sources, managed care contracts, and market competition) were selected. Difference scores were developed and used for the multivariate analysis controlling demographic variables.

(4) Results

IT use for clinical activities were increased, ranged from 15% to 20%, consistently across the all practice settings. Increased use of IT for creating reminders was positively related with increased use of quality of care compensation (OR=1.6/CI=1.1-2.2) but negatively related to increased use of productivity compensation (OR=0.59/CI=0.4-0.85). Number of managed care contract is positively related to increased use of IT for accessing patient notes (OR=1.3/CI=1.04-1.63) and for clinical data exchange (OR=1.29/CI=1.04-1.62).

(5) Discussion/Conclusion

No general impacts were found from compensation and market factor on the four IT activities that have been used more across all practice settings. Factors such as organizational culture and individual preference of IT may affect. Adverse to the increased interest in pay for performance, physician compensation might not so much improve physicians' actual use of IT for clinical activities. Neither is physician IT use related so much with market situations, except the number of managed care contracts, their organizations are facing.