Access to Health Technology Sets Psychiatrists Apart

The study found that 52 percent of psychiatrists were in practices that used information technology to obtain information about treatment alternatives or recommended guidelines, compared with 65 percent of all physicians.

Thirty-six percent of psychiatrists had access to IT for viewing patient notes, medication lists, or problem lists, while 50 percent of all physicians had health IT available for that purpose.

Psychiatrists' access to IT was most similar to the physician average in the category of prescription writing. Twenty percent of psychiatrists had IT for submitting prescriptions, which mirrored the 22 percent of all physicians who had such access.

Digital information systems were available to 34 percent of psychiatrists to exchange clinical data and images with other physicians, while about 50 percent of all types of physicians could access health technology to accomplish that.

Exchanging clinical data and images with hospitals was available through health IT by 34 percent of psychiatrists compared with 66 percent of all physicians.

Twelve percent of all physicians had access to health IT to perform all five of the tasks tracked by the study, while only 2 percent of psychiatrists had access that was that extensive.

“The importance of particular clinical activities to a specialty may affect IT adoption across physician specialties,” said Catherine Corey, M.S.P.H, coauthor of the study, in a written statement. “For example, surgeons may have less need for IT to write prescriptions since they typically prescribe a narrow range of on-formulary medications on a short-term basis in contrast to medical specialists and [primary care physicians] who treat chronically ill patients taking multiple medications.”

In other cases, existing electronic medical record products may not meet the distinct clinical needs of some specialties, such as enhanced drawing features and imaging storage for ophthalmologists monitoring glaucoma patients or growth-tracking capabilities and pediatric dosing calculations for pediatricians, the authors noted.

They cautioned that the findings are considered an upper limit on the proportion of physicians regularly using clinical IT in their practices. This was because physicians were asked only about IT availability in their practice but not whether they actually use the technology or the frequency or intensity of use.

The study highlights the continuing lag by physicians in adopting information technology. Although there are many reasons why physicians have been slow to invest in electronic medical records, according to John Luo, M.D., former president of the American Association for Technology in Psychiatry, concerns by physicians about the security of health information exchanges may be one of the biggest. He pointed out that unlike other areas of e-commerce, health care technology vendors have yet to agree on a standard for information exchange.

Another factor delaying adoption is the lack of national standards for electronic health care transactions, although the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required their development.

The lack of financial incentives for adopting electronic medical records and legal concerns—such as laws in some states that prohibit hospitals from giving technology to their referring physicians—also stand in the way of achieving its broader adoption, Luo noted in a 2006 column in Primary Psychiatry.

Information on HSC's Data Bulletin, “Clinical Information Technology Adoption Varies Across Physician Specialties,” is posted at</www.hschange.org/CONTENT/945/>.▪