Dataset Information

Primary Care Physicians' Satisfaction With Interoperable Health Information Technology.

ABSTRACT:

Importance

Enabling widespread interoperability-the ability of health information technology systems to exchange information and to use that information without special effort-is a primary focus of public policy on health information technology. More information on clinicians' experience using that technology can serve as one measure of the impact of that policy.

Objective

To assess primary care physician perspectives on the state of interoperability.

Design, setting, and participants

A cross-sectional survey of family medicine physicians in the US was conducted from December 12, 2021, to October 12, 2022. A sample of family medicine physicians who completed the Continuous Certification Questionnaire (CCQ), a required part of the American Board of Family Medicine certification process, which has a 100% response rate, were invited to participate.

Main outcomes and measures

Eighteen items on the CCQ assessed experience accessing and using various information from outside organizations, including medications, immunizations, and allergies.

Results

A total of 2088 physicians (1053 women [50%]; age reported categorically as either ≥50 years or <50 years) completed the CCQ interoperability questions in 2022. Of these respondents, 35% practiced in hospital or health system-owned practices, while 27% practiced in independently owned practices. Eleven percent were very satisfied with their ability to electronically access all 10 types of information from outside organizations included on the questionnaire, and a mean of 70% were at least somewhat satisfied. A total of 23% of family medicine physicians reported information from outside organizations was very easy to use, and an additional 65% reported that information was somewhat easy to use. Only 8% reported that information from different electronic health record (EHR) developers' products was very easy to use compared with 38% who reported information from the same EHR developer's product was very easy to use.

Conclusions and relevance

This survey study of family medicine physicians found modest and uneven improvement in physicians' experience with interoperability. These findings suggest that substantial heterogeneity in satisfaction by information type, source of information, EHR, practice type, ownership, and patient population necessitates diverse policy and strategies to improve interoperability.

SUBMITTER: Everson J

PROVIDER: S-EPMC10966410 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Primary Care Physicians' Satisfaction With Interoperable Health Information Technology.

Everson Jordan J Hendrix Nathaniel N Phillips Robert L RL Adler-Milstein Julia J Bazemore Andrew A Patel Vaishali V

JAMA network open 20240304 3

<h4>Importance</h4>Enabling widespread interoperability-the ability of health information technology systems to exchange information and to use that information without special effort-is a primary focus of public policy on health information technology. More information on clinicians' experience using that technology can serve as one measure of the impact of that policy.<h4>Objective</h4>To assess primary care physician perspectives on the state of interoperability.<h4>Design, setting, and parti ...[more]

PMID: 38530309

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Project description:BackgroundIn 2014, Indonesia launched a mandatory national health insurance system called Jaminan Kesehatan Nasional (JKN). The reform introduced new conditions for primary care physicians (PCPs) that could influence their job satisfaction. This study assessed PCPs' satisfaction and its predictors in two cities in Central Java, Indonesia, following the reform.MethodsIn this exploratory, cross-sectional study, we recruited 276 PCPs from the selected area. The data were all collected in 2016 using self-report questionnaires and interviews. PCPs' satisfaction was measured using a modified version of the Warr-Cook-Wall Job Satisfaction Scale which contains 19 items and uses a Likert-type response scale. Analysis of variance, the Kruskal-Wallis H test, both with Bonferroni corrections for post hoc testing, and Cochran-Mantel-Haenszel tests were used to compare overall job satisfaction between participant groups. We used simple and multiple linear regression analyses to identify the predictors of PCP satisfaction. Furthermore, a logistic regression analysis for binary outcome was applied to model the PCPs intention to leave practice.ResultsPCPs' mean overall satisfaction level was 3.19 out of 5. They tended to be very satisfied with their relationship with colleagues, working hours, and physical working conditions. However, the PCPs were dissatisfied with the new referral system, the JKN health services standards, and JKN policy. The factors significantly associated with job satisfaction (p < 0.001) included type of practice, performance of managerial tasks, and PCPs' perceptions of and experiences with patients. PCP satisfaction was negatively associated (p = 0.004) with PCPs' intention to leave their practice.ConclusionsThe PCPs investigated in these two cities in Central Java had moderate satisfaction after the Indonesian health care reform. PCPs who worked in solo practices, performed managerial tasks, and had good experiences with patients tended to have higher satisfaction scores, which in turn prevented them from developing an intention to leave their practice. The three aspects that PCPs with which most dissatisfied were related with the JKN reform. Because of that, the government and BPJS for Health should aim to improve the JKN system in order to increase PCPs' satisfaction.

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Project description:ImportanceMore conservative prescribing has the potential to reduce adverse drug events and patient harm and cost; however, no method exists defining the extent to which individual clinicians prescribe conservatively. One potential domain is prescribing a more limited number of drugs. Personal formularies-defined as the number and mix of unique, newly initiated drugs prescribed by a physician-may enable comparisons among clinicians, practices, and institutions.ObjectivesTo develop a method of defining primary care physicians' personal formularies and examine how they differ among primary care physicians at 4 institutions; evaluate associations between personal formularies and patient, physician, and practice site characteristics; and empirically derive and examine the variability of the top 200 core drugs prescribed at the 4 sites.Design, setting, and participantsThis retrospective cohort study was conducted at 4 US health care systems among 4655 internal and family medicine physicians and 4 930 707 patients who had at least 1 visit to these physicians between January 1, 2017, and December 31, 2018.ExposuresPersonal formulary size was defined as the number of unique, newly initiated drugs.Main outcomes and measuresPersonal formulary size and drugs used, physician and patient characteristics, core drugs, and analysis of selected drug classes.ResultsThe study population included 4655 primary care physicians (2274 women [48.9%]; mean [SD] age, 48.5 [4.4] years) and 4 930 707 patients (16.5% women; mean [SD] age, 51.9 [8.3] years). There were 41 378 903 outpatient prescriptions written, of which 9 496 766 (23.0%) were new starts. Institution median personal formulary size ranged from 150 (interquartile range, 82.0-212.0) to 296 (interquartile range, 230.0-347.0) drugs. In multivariable modeling, personal formulary size was significantly associated with panel size (total number of unique patients with face-to-face encounters during the study period; 1.2 medications per 100 patients), physician's total number of encounters (5.7 drugs per 10% increase), and physician's sex (-6.2 drugs per 100 patients for female physicians). There were 1527 unique, newly prescribed drugs across the 4 sites. Fewer than half the drugs (626 [41.0%]) were used at every site. Physicians' prescribing of drugs from a pooled core list varied from 0% to 100% of their prescriptions.Conclusions and relevancePersonal formularies, measured at the level of individual physicians and institutions, reveal variability in size and mix of drugs. Similarly, defining a list of commonly prescribed core drugs in primary care revealed interphysician and interinstitutional differences. Personal formularies and core medication lists enable comparisons and may identify outliers and opportunities for safer and more appropriate prescribing.

Dataset Information

Primary Care Physicians' Satisfaction With Interoperable Health Information Technology.

Importance

Objective

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Publications

Primary Care Physicians' Satisfaction With Interoperable Health Information Technology.

Similar Datasets

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