A total of 1345 physicians (71%, 1345 of 1884) completed the survey, 1328 by mail and 17 by phone. There were no significant differences between respondents and non-respondents on the sampling characteristics (specialty, practice size, hospital affiliation, and rural practice). The practices reported using a wide variety of commercially available and self-developed EHR systems. shows the practice characteristics. Note that some respondents omitted certain questions on the survey so the number of practices does not always add up to 1345. The rural/urban classification was applied based on practice location, so it was available for all practices.
Among the 356 practices which had an EHR and reported its name, a total of 187 (52.5%) used one of the 4 most prevalent systems while the remaining 169 (47.5%) reported using one of 78 other systems that were named. There were also 31 practices that reported having an EHR but did not provide its name—they were still counted as having an EHR for purposes of the analysis.
Overall, 79.8% of physicians reported that their practices could generate registries of patients with a particular diagnosis; 56.1% could generate registries of patients with a specific laboratory result; and 55.8% could generate registries of patients taking a particular medication. Among physicians who reported that their practices were able to generate registries, the reported ease with which such registries could be generated varied greatly, as shown in . While 38.9% of physician practices that could generate diagnosis registries said their practice could do it easily or very easily, considerably fewer said that it was easy or very easy to generate registries based on laboratory test results (14.5%) or medications (17.8%).
Ease or difficulty of generating registries of patients based on diagnosis, laboratory result and medication usea
shows the proportion of physician practices that were capable of carrying out registry functions, stratified by pre-specified subgroups of interest. For all three registry types, providers with EHRs were significantly more likely to be able to perform registry functions than providers using non-electronic record systems (P < .001 for all three registry types). Also, larger practices, practices involved in teaching, hospital-based practices, and primary care practices were more likely to be able to generate registries.
Ability to perform registry functions according to practice characteristics (these data are weighted but not adjusted for confounding factors)
In logistic regression analyses controlling for urban/rural location, practice size, practice ownership, teaching status, hospital affiliation, and practice type, the relationship between the presence of EHR and the ability to carry out each registry function remained robust. EHR adopters were more likely than non-adopters to be able to develop registries based on diagnosis (adjusted odds ratio [OR] 1.53, 95% confidence interval [CI] 1.25 - 1.86), laboratory results (OR 1.42, 95% CI, 1.22 - 1.66), and medications (OR 2.30, 95% CI, 1.96 - 2.70). Rural location, practice size, practice ownership, hospital affiliation, and practice type also remained significant correlates of one or more registry capability in the multivariate analyses ().
Multivariate correlates of registry function capability
We also observed a relationship between use of key EHR features and ability to perform related registry functions. Specifically, within the group of physicians who had access to an EHR in their practice, 90.4% of physicians who reported using an electronic problem list at least some of the time had the ability to perform diagnosis registry functions, while only 67.7% of physicians using an EHR without access to an electronic problem list could perform these functions (P < .001). Similarly, while 75.2% of physicians who used an electronic medication list could perform medication registry functions, only 53.0% of physicians who used an EHR without a medication list reported they could perform them (P < .001). Finally, while 71.5% of physicians who used their EHR to view laboratory results could perform laboratory registry functions, only 33.9% of physicians whose EHR could not be used to view laboratory results reported they could perform these functions (P < .001).