Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Jamoom E[original query] |
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Physician opinions about EHR use by EHR experience and by whether the practice had optimized its EHR use
Jamoom EW , Heisey-Grove D , Yang N , Scanlon P . J Health Med Inform 2016 7 (4) 1000240 Optimization and experience with using EHRs may improve physician experiences. Physician opinions about EHR-related impacts, and the extent to which these impacts differ by self-reported optimized EHR use and length of experience are examined through nationally representative physician data of EHR users from the National Electronic Health Records Survey extended survey (n=1,471). Logistic regression models first estimated how physicians' length of times using an EHR were associated with each EHR-related impact. Additionally, a similar set of models estimated the association of self-reported optimized EHR use with each EHR impact. At least 70% of physicians using EHRs continue to attribute their administrative burdens to their EHR use. Physicians with 4 or more years of EHR experience accounted for 58% of those using EHRs. About 71% of EHR users self-reported using an optimized EHR. Physicians with more EHR experience and those in practices that optimized EHR use had positive opinions about the impacts of using EHRs, compared to their counterparts. These findings suggest that longer experience with EHRs improves perceptions about EHR use; and that perceived EHR use optimization is crucial to identifying EHR-related benefits. Finding ways to reduce EHR-related administrative burden has yet to be addressed. |
Determining Sufficient Number of Imputations Using Variance of Imputation Variances: Data from 2012 NAMCS Physician Workflow Mail Survey
Pan Q , Wei R , Shimizu I , Jamoom E . Appl Math (Irvine) 2014 5 3421-3430 How many imputations are sufficient in multiple imputations? The answer given by different researchers varies from as few as 2 - 3 to as many as hundreds. Perhaps no single number of imputations would fit all situations. In this study, η, the minimally sufficient number of imputations, was determined based on the relationship between m, the number of imputations, and ω, the standard error of imputation variances using the 2012 National Ambulatory Medical Care Survey (NAMCS) Physician Workflow mail survey. Five variables of various value ranges, variances, and missing data percentages were tested. For all variables tested, ω decreased as m increased. The m value above which the cost of further increase in m would outweigh the benefit of reducing ω was recognized as the η. This method has a potential to be used by anyone to determine η that fits his or her own data situation. |
EHR adopters vs. non-adopters: impacts of, barriers to, and federal initiatives for EHR adoption
Jamoom EW , Patel V , Furukawa MF , King J . Healthc (Amst) 2014 2 (1) 33-39 While adoption of electronic health record (EHR) systems has grown rapidly, little is known about physicians' perspectives on its adoption and use. Nationally representative survey data from 2011 are used to compare the perspectives of physicians who have adopted EHRs with those that have yet to do so across three key areas: the impact of EHRs on clinical care, practice efficiency and operations; barriers to EHR adoption; and factors that influence physicians to adopt EHRs. Despite significant differences in perspectives between adopters and non-adopters, the majority of physicians perceive that EHR use yields overall clinical benefits, more efficient practices and financial benefits. Purchase cost and productivity loss are the greatest barriers to EHR adoption among both adopters and non-adopters; although non-adopters have significantly higher rates of reporting these as barriers. Financial incentives and penalties, technical assistance, and the capability for electronic health information exchange are factors with the greatest influence on EHR adoption among all physicians. However, a substantially higher proportion of non-adopters regard various national health IT policies, and in particular, financial incentives or penalties as a major influence in their decision to adopt an EHR system. Contrasting these perspectives provides a window into how national policies have shaped adoption thus far; and how these policies may shape adoption in the near future. 2014. |
Clinical benefits of electronic health record use: national findings
King J , Patel V , Jamoom EW , Furukawa MF . Health Serv Res 2014 49 392-404 OBJECTIVE: To assess whether physicians' reported electronic health record (EHR) use provides clinical benefits and whether benefits depend on using an EHR meeting Meaningful Use criteria or length of EHR experience. DATA SOURCE: The 2011 Physician Workflow study, representative of U.S. office-based physicians. STUDY DESIGN: Cross-sectional data were used to examine the association of EHR use with enhanced patient care overall and nine specific clinical benefits. PRINCIPAL FINDINGS: Most physicians with EHRs reported EHR use enhanced patient care overall (78 percent), helped them access a patient's chart remotely (81 percent), and alerted them to a potential medication error (65 percent) and critical lab values (62 percent). Between 30 and 50 percent of physicians reported that EHR use was associated with clinical benefits related to providing recommended care, ordering appropriate tests, and facilitating patient communication. Using EHRs that met Meaningful Use criteria and having 2 or more years of EHR experience were independently associated with reported benefits. Physicians with EHRs meeting Meaningful Use criteria and longer EHR experience were most likely to report benefits across all 10 measures. CONCLUSIONS: Physicians reported EHR use enhanced patient care overall. Clinical benefits were most likely to be reported by physicians using EHRs meeting Meaningful Use criteria and longer EHR experience. |
Variation in electronic health record adoption and readiness for meaningful use: 2008-2011
Patel V , Jamoom E , Hsiao CJ , Furukawa MF , Buntin M . J Gen Intern Med 2013 28 (7) 957-64 BACKGROUND: Federal initiatives are underway that provide physicians with financial incentives for meaningful use (MU) of electronic health records (EHRs) and assistance to purchase and implement EHRs. OBJECTIVE: We sought to examine readiness and interest in MU among primary care physicians and specialists, and identify factors that may affect their readiness to obtain MU incentives. DESIGN/PARTICIPANTS: We analyzed 4 years of data (2008-2011) from the National Ambulatory Medical Care Survey (NAMCS) Electronic Medical Record (EMR) Supplement, an annual cross-sectional nationally representative survey of non-federally employed office-based physicians. MAIN MEASURES: Survey-weighted EHR adoption rates, potential to meet selected MU criteria, and self-reported intention to apply for MU incentives. We also examined the association between physician and practice characteristics and readiness for MU. KEY RESULTS: The overall sample consisted of 10,889 respondents, with weighted response rates of 62 % (2008); 74 % (2009); 66 % (2010); and 61 % (2011). Primary care physicians' adoption of EHRs with the potential to meet MU nearly doubled from 2009 to 2011 (18 % to 38 %, p < 0.01), and was significantly higher than specialists (19 %) in 2011 (p < 0.01). In 2011, half of physicians (52 %) expressed their intention to apply for MU incentives; this did not vary by specialty. Multivariate analyses report that EHR adoption was significantly higher in both 2010 and 2011 compared to 2009, and primary care physicians and physicians working in larger or multi-specialty practices or for HMOs were more likely to adopt EHRs with the potential to meet MU. CONCLUSIONS: Physician EHR adoption rates increased in advance of MU incentive payments. Although interest in MU incentives did not vary by specialty, primary care physicians had significantly higher rates of adopting EHRs with the potential to meet MU. Addressing barriers to EHR adoption, which may vary by specialty, will be important to enhancing coordination of care. |
Physicians in nonprimary care and small practices and those age 55 and older lag in adopting electronic health record systems
Decker SL , Jamoom EW , Sisk JE . Health Aff (Millwood) 2012 31 (5) 1108-14 By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care. We found that although trends in adoption of electronic health record systems across geographic regions converged from 2002 through 2011, adoption continued to lag for non-primary care specialists, physicians age fifty-five and older, and physicians in small (1-2 providers) and physician-owned practices. Federal policies are specifically aimed at encouraging primary care providers and small practices to achieve widespread use of electronic health records. To achieve their nationwide adoption, federal policies may also have to focus on encouraging adoption among non-primary care specialists, as well as addressing persistent gaps in the use of electronic record systems by practice size, physician age, and ownership status. |
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