General practitioners' use of computers for prescribing and electronic health records: results from a national survey
Starting in the late 1990's the Australian government has put a lot of effort in improving healthcare quality promoting health information technology as a strategy. For that purpose incentives were provided for the installation of hardware and software for clinical purposes like electronic charting and prescription. This initiative helped to increase the use of computers in clinical settings from 15% in 1997 to 70% in 2000. The objective of this work is to provide an update on how general practitioners use computers for clinical purposes and what range of functions are they using of these applications. A random sample of 3000 general practitioners from the Medicare databases of the Australian Government of Health and Ageing were mailed a survey that addressed on the use of the following items:
- Electronic health record functions
- Electronic prescription
- Computerized lists of patients
- Electronic information resources for clinical decision support
The physicians were stratified as 70% from urban or regional areas and 30% from rural or remote areas. Results: Questionnaires were returned by 39.5% of the 3000 general practitioners. Most of the respondents (89.5%) used computers for clinical purposes; in this group 55.6% had received an incentive for the use of information technology. Nearly all (98%) of the practitioners that used computers in the office also used electronic prescription and between 70% and 94% also updated the patients medication list or checked for interactions between drugs, drug allergies or drug and diseases. The electronic health record functions that were more commonly used were: ordering laboratory tests (84.9%), updating patient allergy information (84%), generating heath summaries (83.5%) and writing referral letters (81.1%). The use of computerized list of patients by conditions, medication or for indicating vaccines ranged between 39.1% to 58.3%. The least used functions were those related with use of knowledge based resources like the review of guidelines (10.2%) or assessment of risk factors (16.2%). These figures show that Australia has importantly increased the use of computers for clinical applications mainly in electronic prescribing, but still needs to encourage the adoption of other features that might help to improve healthcare quality through the use of IT.
Australia has reached an important national coverage in the use of information technology in healthcare in the general practitioners area. This project has been encouraged by incentives given to physicians for the acquisition of hardware, software and internet connectivity. The use of clinical applications have increased, but there is still some issues regarding the use of applications that can help in improving clinical outcomes in patients, such as the use of knowledge based resources that can help in the correct management of chronic diseases.