Computer use in primary care practices in Canada

Yvonne Anisimowicz; Andrea E Bowes; Ashley E Thompson; Baukje Miedema; William E Hogg; Sabrina T Wong; Alan Katz; Fred Burge; Kris Aubrey-Bassler; Gregory S Yelland; Walter P Wodchis

Computer use in primary care practices in Canada

Can Fam Physician. 2017 May;63(5):e284-e290.

Authors

Affiliations

¹ Research assistant at the Dalhousie Family Medicine Teaching Unit in Fredericton, NB.
² New Brunswick SPOR (Strategy for Patient-Oriented Research Network) coordinator in Fredericton.
³ Assistant Professor in the Department of Psychology at University of Wisconsin-Oshkosh.
⁴ Professor and Director of Research at the Dalhousie Family Medicine Teaching Unit in Fredericton. baukjemiedema@gmail.com.
⁵ Scientist at the Élisabeth Bruyère Research Institute in Ottawa, Ont, and Professor and Senior Research Advisor in the Department of Family Medicine at the University of Ottawa and the C.T. Lamont Primary Health Care Research Centre.
⁶ Director of the Centre for Health Services and Policy Research at the University of British Columbia in Vancouver.
⁷ Professor in the Department of Family Medicine and the Department of Community Health Sciences and Director of Research at the University of Manitoba in Winnipeg, and Director of the Manitoba Centre for Health Policy.
⁸ Professor and Research Director of the Primary Care Research Unit in the Department of Family Medicine at Dalhousie University in Halifax, NS, and the science lead for Building Research for Integrated Primary Healthcare.
⁹ Director of the Centre for Rural Health Studies at Memorial University of Newfoundland in St John's.
¹⁰ Program evaluation consultant for the Quality Health Council of Alberta in Edmonton.
¹¹ Associate Professor in the Institute of Health Policy, Management and Evaluation at the University of Toronto in Ontario.

PMID: 28500211
PMCID: PMC5429070

Abstract
in English, French

Objective: To examine the use of computers in primary care practices.

Design: The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data.

Setting: All 10 Canadian provinces.

Participants: A total of 788 family physicians.

Main outcome measures: A computer use scale measured the extent to which family physicians integrated computers into their practices, with higher scores indicating a greater integration of computer use in practice. Analyses included t tests and ² tests comparing new and traditional models of primary care on measures of computer use and electronic health record (EHR) use, as well as descriptive statistics.

Results: Nearly all (97.5%) physicians reported using a computer in their practices, with moderately high computer use scale scores (mean [SD] score of 5.97 [2.96] out of 9), and many (65.7%) reported using EHRs. Physicians with practices operating under new models of primary care reported incorporating computers into their practices to a greater extent (mean [SD] score of 6.55 [2.64]) than physicians operating under traditional models did (mean [SD] score of 5.33 [3.15]; t_726.60 = 5.84; P < .001; Cohen d = 0.42, 95% CI 0.808 to 1.627) and were more likely to report using EHRs (73.8% vs 56.7%; [Formula: see text]; P < .001; odds ratio = 2.15). Overall, there was a statistically significant variability in computer use across provinces.

Conclusion: Most family physicians in Canada have incorporated computers into their practices for administrative and scholarly activities; however, EHRs have not been adopted consistently across the country. Physicians with practices operating under the new, more collaborative models of primary care use computers more comprehensively and are more likely to use EHRs than those in practices operating under traditional models of primary care.

Objectif: Vérifier l’utilisation qu’on fait de l’ordinateur dans les cliniques de soins primaires.

Type d’étude: L’étude Quality and Costs of Primary Care a été effectuée en 2013 et 2014 à l’aide d’enquêtes descriptives transversales dans le but de recueillir des données sur la pratique médicale au Canada. Les cliniques participantes ont répondu à plusieurs de ces enquêtes, notamment au Sondage national des médecins; ce sont les données de cette étude que nous avons utilisées.

Contexte: Les 10 provinces du Canada.

Participants: Un total de 788 médecins de famille.

Principaux paramètres à l’étude: On a utilisé une échelle d’utilisation de l’ordinateur pour déterminer à quel point les médecins de famille utilisaient l’ordinateur dans leur pratique, les scores élevés indiquant une meilleure intégration de cet outil dans leur pratique. Les analyses incluaient des tests de t et de formula image ² pour savoir si l’utilisation de modèles nouveaux ou traditionnels pour les soins primaires avaient une influence sur l’adoption du dossier électronique de santé (DES); des statistiques descriptives ont aussi été utilisées.

Résultats: Presque tous les médecins (97,5 %) ont déclaré se servir de l’ordinateur dans leur pratique, avec des scores modérément élevés (score moyen [DS] de 5,97 [2,96] sur 9) tandis que plusieurs (65,7 %) mentionnaient l’utiliser pour le DES. D’après leurs déclarations, les médecins exerçant dans des cliniques utilisant les nouveaux modèles de soins primaires étaient de plus grands utilisateurs de l’ordinateur que ceux qui travaillaient selon le modèle traditionnel (score moyen [DS] de 6,55 [2,64] contre 5,33 [3,15]; t_726,60 = 5.,84; P < ,001; d de Cohen = 0,42, IC à 95 % 0,808 à 1,627); ils étaient aussi plus susceptibles de dire qu’ils utilisaient le DES (73,8 % contre 56,7 %; $χ_{1}^{2} = 25, 43$ ; P < ,001; rapport de cotes = 2,15). On notait aussi que l’utilisation de l’ordinateur varie de façon significative entre les provinces.

Conclusion: Au Canada, la plupart des médecins de famille ont intégré l’ordinateur à leur pratique pour des activités d’ordre administratif ou pour de la formation; toutefois, cet outil n’a pas été adopté de manière égale partout dans le pays. Les médecins qui exercent selon de nouveaux modèles de soins primaires, davantage axés sur la collaboration, utilisent l’ordinateur de façon plus globale et sont plus susceptibles d’utiliser les DES que ceux qui fonctionnent selon des modèles traditionnels de soins primaires.

MeSH terms

Adult
Aged
Aged, 80 and over
Canada
Computers / statistics & numerical data*
Cross-Sectional Studies
Electronic Health Records / statistics & numerical data*
Female
Health Care Surveys
Humans
Male
Middle Aged
Physicians, Primary Care / statistics & numerical data*
Primary Health Care / methods*
Primary Health Care / statistics & numerical data
Young Adult

Abstract in English, French

MeSH terms

Abstract
in English, French