Physician practice revenues and use of information technology in patient care

Objectives: Although information technology (IT) may improve efficiency and quality of patient care, the adoption of clinical IT by physicians has been limited. This study investigates the relationships between physician practice revenue and use of clinical IT. Research Design: We undertook a cross-sectional analysis of data on 6849 U.S. physicians in physician-owned practices who responded to the 2000-2001 Community Tracking Study Physician Survey. Physician practice revenues, measured as the percentage of total revenues, is defined along 2 dimensions: type (capitation, noncapitated managed care, or fee-for-service) and source (Medicare, Medicaid, or private/other). Analyses were adjusted for physician and practice characteristics and geographic location. Measures: The proportion of physicians using IT for 5 functions of patient care: treatment guidelines, formularies, patient notes or lists, electronic prescriptions, and data exchange with other physicians. Results: Practice revenues are associated with differences in physicians' use of IT in patient care. Above-average Medicaid revenue was associated with 20% higher use of IT overall (incidence density ratio = 1.20, 95% confidence interval [CI] = 1.12-1.30). Above-average capitation revenue corresponds to higher use of IT overall (incidence density ratio = 1.10, 95% Cl = 1.02-1.19) and greater odds of using IT for guidelines (odds ratio = 1.26, 95% CI = 1.05-1.53). Above-average noncapitated managed care revenue, however, has no apparent relationship with IT use. Conclusions: Differences in the type and source of physician revenues were associated with differences in the use of IT in patient care in 2000-2001. The relationships between practice revenues and IT use varied across clinical IT functions.