Most Medicare Outpatient Visits are to Physicians with Limited Clinical Information Technology

Originally published by the Center for Studying Health System Change (HSC) as Data Bulletin No. 30, July 2005.

Medicare Patients' Limited Access to Physicians with Clinical IT

Adoption of clinical information technology in physician practices holds considerable potential to improve quality and reduce costs for patients with complex health problems, including many Medicare beneficiaries. A baseline analysis by the Center for Studying Health System Change, linking Medicare claims data to the Community Tracking Study Physician Survey, found that a majority of Medicare fee-for-service outpatient visits in 2001 were to physicians without significant IT support for patient care.

More than half of Medicare outpatient visits (57%) were to physicians in practices that used IT for no more than one of five key clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing patient notes, generating preventive treatment reminders, and writing prescriptions. Access rates varied considerably across individual functions. While half of visits were to practices using IT for treatment guidelines, only 9 percent of visits were to practices with electronic prescribing capability.

More vulnerable Medicare beneficiaries, including those who were sicker, living in low-income or rural areas, or who were black, did not show significant differences in access to physicians with clinical IT compared with other beneficiaries. This was because limited IT adoption was so widespread across physician practices that it affected patients broadly, regardless of their demographic characteristics. Medicare beneficiaries' restricted access to physicians with clinical IT mirrored patterns in the general population, reflecting the slow overall pace of technology adoption in physician practices at the time.

Sources and Further Reading

Grossman, Joy M., and Marie C. Reed, "Most Medicare Outpatient Visits are to Physicians with Limited Clinical Information Technology," Data Bulletin No. 30, Center for Studying Health System Change (July 2005).