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Study Finds Clinical IT Gaps Grow Between Small and Large Physician Practices

By CQ Staff

November 9, 2006 -- Physicians in smaller practices continue to lag well behind those in larger practices in reporting the availability of clinical information technology in their offices, according to a Center for Studying Health System Change (HSC) report issued Thursday.

The proportion of physicians reporting access to clinical information technology (IT) for each of five clinical activities increased across all practice settings between 2000–01 and 2004–05. But adoption gaps between small and large practices persisted for two of the clinical activities—obtaining treatment guidelines and exchanging clinical data with other physicians. The gaps widened for the other three—accessing patient notes, generating preventive care reminders, and writing prescriptions—according to the study, which was funded by the Robert Wood Johnson Foundation.

In the case of access to IT to write prescriptions, the adoption gap between small (1 to 9 physicians) and large (51-plus physicians) group practices more than tripled between 2000–01 and 2004–05, the study found. In 2000–01, 8 percent of physicians in small group practices reported access to IT to write prescriptions, with the proportion growing to 13 percent in 2004–05. In contrast, 19 percent of physicians in large group practices reported access to IT to write prescriptions in 2000–01, but the proportion grew to 47 percent by 2004–05.

"The differences may reflect a natural path of technology adoption where larger, savvier organizations adopt new technologies first and others follow, albeit at a slower rate," the study's co-author and HSC senior health researcher Joy M. Grossman said in a news release. "Or it may be that smaller practices face different and substantial barriers that affect how quickly they catch up, if ever."

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