Date of Award

2010

Degree Type

Thesis

Degree Name

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Sisira Sarma

Second Advisor

Dr. Amardeep Thind

Abstract

Objective: To evaluate the impact of health information technology on primary care physicians in Canada by the number of medical services and clinical procedures they offer, total direct patient care hours provided, and visit duration. Methods: We used nationally representative data from the 2007 National Physician Survey to examine the extent of Health Information Technology (HIT count and HIT type) on the scope of practice, total direct patient care hours, and length of office visits among family physicians/general practitioners. HIT count is defined as the number of HIT the physician uses and HIT type is categorical variable based on its features. Negative binomial regression models were used to assess the number of medical services and clinical procedures offered. Linear regression models were used to assess the total direct patient care hours and visit duration. Results: Multivariate analyses show a significant increase in the expected mean number of medical services offered, clinical procedures offered, direct patient care hours, and visit duration with each additional HIT the physician uses in his/her practice. The greatest positive impact was found among physicians who uses EMR-Plus HIT for medical services (8.8 percent, p<0.01) and clinical procedures (8.7 percent, p<0.01) when compared to non-HIT users. Physicians were found to increase their time spent per patient visit who use EMR HIT by 7.8 percent (p<0.05) and EMR-Plus HIT by 6.8 percent (p<0.01) when compared to non-HIT users. No significant association was found between the different HIT types physician uses and total direct patient care hours. Conclusion: The use of health information technology is found to be associated with an increase of medical services and clinical procedures offered, and duration of visit. Limited impact of HIT was found to be associated with total direct patient care hours. Further investigation of what components in HIT affects the workflow of family physicians is needed. Overall, careful consideration needs to be taken when investing and implementing HIT in Canada because there may be unintended consequences.

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