The good, the bad and the early adopters: providers' attitudes about a common, commercial EHR

J Eval Clin Pract. 2014 Feb;20(1):36-42. doi: 10.1111/jep.12076. Epub 2013 Aug 20.


Rationale, aims and objectives: To describe primary care providers' (PCP) attitudes about the impact of a mature, commercial electronic health records (EHR) on clinical practice in settings with experience using the system and to evaluate whether a provider's propensity to adopt new technologies is associated with more favourable perceptions.

Method: We surveyed PCPs in 11 practices affiliated with three health systems in Texas. Most practices had greater than 5 years of experience with the Epic EHR. The effect of early adopter of technology status was evaluated using logistic regression.

Results: One hundred forty-six PCPs responded (70%). Most thought the EHR had a positive impact on routine tasks, such as prescription refills (94%), whereas fewer agreed for complex tasks, such as delivery of guideline-concordant care for chronic illnesses (51%). Two-thirds (62%) thought it interfered with eye contact with patients, and 40% reported that it interfered with in-visit communication. Early adopters of technology reported greater positive effects of the EHR, even after adjusting for age, ranging from 2% to 15% higher on satisfaction ratings.

Conclusion: PCPs practicing in settings with considerable experience using a common commercial EHR identified many positive effects, as well as two key areas for improvement - patient centredness and intelligent decision support. Providers with a propensity to adopt new technologies have more favourable perceptions of the EHR.

Keywords: attitude of health personnel; attitude to computers; early adopter; electronic health record; physicians; primary care; primary health care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Attitude to Computers
  • Electronic Health Records / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care*
  • Quality of Health Care