Assessing attitudes toward electronic prescribing adoption in primary care: a survey of prescribers and staff

Abstract

Background: Using survey instruments to assess physicians' attitudes toward electronic health record (EHR) adoption has been an ongoing area of research. No instrument has emerged for widespread use.

Objective: We used a theoretically-based, 37-question survey instrument to assess attitudes toward electronic (e-) prescribing adoption in the context of an existing EHR. Our objective was to elicit information to inform strategies to maximise adoption.

Methods: The instrument assesses attitudes in four domains: finesse, intent to use technology, perceived usefulness and perceived ease of use. Two additional questions ask about computer use at home and self-assessed computer knowledge. We administered the instrument to prescribers and staff at three primary care sites between 2005 and 2007. Each site represented a unique transition from paper-based or partial (Phase 1) to full (Phase 2) e-prescribing use.

Results: Fifty-nine prescribers (82% response) and 58 staff (50% response) completed the survey. At the paper-based site, domain scores increased significantly from Phase 1 to Phase 2 for intent to use technology for both prescribers (4.8 to 5; P<0.04) and staff (4 to 5; P<0.03); and for perceived usefulness for staff (3.7 to 4.6; P<0.02). For prescribers, significant associations (P<0.05) were found between computer use at home for professional use and each domain score; and between computer knowledge and three of the four domains. Self-assessed computer knowledge was consistently rated as intermediate, vs novice or expert.

Conclusions: Domain scores improved. Prescribers' self-assessment of computer use at home and computer knowledge predicted attitudes toward adoption. This instrument may be useful in tailoring strategies for successful adoption.