Adoption of health information technology in patient-centered medical homes

Background: Health information technology (HIT) plays a foundational role in patient-centered medical home (PCMH) initiatives their ability to promote efficient, high quality, and safe care. Yet, low adoption of HIT can reduce its ability to achieve these objectives. A better understanding of current HIT usage in PCMH and factors associated with implementation can identify the gaps, help promote HIT adoption.

Objectives: 1) To examine the type and level of HIT usage in PCMH; 2) To examine the relationship between characteristics of physician practices and their level of HIT usage.

Methods: Data were collected from a statewide survey of physician practices (n=831) throughout Michigan participating in the Blue-Cross/Blue-Shield of Michigan's Physician Group Incentive Program in 2008-2010. Physician practice characteristics included type of physician organization, practice size, and practice specialty. Univariate and bivariate analyses were used to examine the frequency of HIT use and its association with physician practice characteristics.

Results: Of 831 physician practices, the most commonly used HIT types were: practice management system software (58%), electronic prescribing software (51%), followed by electronic medical record systems (31%), and patient registry software (29%). Only 4% of practices used patient portal software and/or personal health records (PHR). Community Health Centers were more likely to use e-prescribing compared with Hospital-based physician practices (61% vs. 42%, p=0.01), There were no statistically significant differences in HIT use with respect to practice size or physician specialty.

Discussion: Despite its important role in the PCMH, overall usage is varied across the different types of HIT application, especially low adoption rates for patient portal and PHR. Our results indicated that factors such as size and specialty do not account for these differences. Further studies exploring the reasons for uneven adoption across different types of HIT can be important for identifying barriers and promoting more widespread use of HIT.