Managing Conflicts and Maximizing Transparency in Industry-Funded Research.

Background: Industry funding of research comes with important conflicts of interest, especially when research findings have financial implications for funders. When considering industry funding, academic investigators seek ways to mitigate and manage conflict to ensure integrity of research design, analysis, interpretation, and to protect researchers' and their institutions' credibility. This qualitative study's purpose was to conduct semi-structured interviews with expert stakeholders to gain insight into industry funding of research focused on nutrition and obesity, and determine the feasibility of developing a transparent process using an advisory board to help govern industry funding and manage conflict.

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years.

Objective: The benefits of antibiotic treatment during pregnancy are immediate, but there may be long-term risks to the developing child. Prior studies show an association between early life antibiotics and obesity, but few have examined this risk during pregnancy.

Subjects: To evaluate the association of maternal antibiotic exposure during pregnancy on childhood BMI-z at 5 years, we conducted a retrospective cohort analysis.

Factors associated with difficult electronic health record implementation in office practice.

Little is known about physicians' perception of the ease or difficulty of implementing electronic health records (EHR). This study identified factors related to the perceived difficulty of implementing EHR. 163 physicians completed surveys before and after the implementation of EHR in an externally funded pilot program in three Massachusetts communities.

Physician satisfaction following electronic health record adoption in three massachusetts communities.

Background: Despite mandates and incentives for electronic health record (EHR) adoption, little is known about factors predicting physicians' satisfaction following EHR implementation.

Objective: To measure predictors of physician satisfaction following EHR adoption.

Methods: A total of 163 physicians completed a mailed survey before and after EHR implementation through a statewide pilot project in Massachusetts.

Are physicians' perceptions of healthcare quality and practice satisfaction affected by errors associated with electronic health record use?

Background: Electronic health record (EHR) adoption is a national priority in the USA, and well-designed EHRs have the potential to improve quality and safety. However, physicians are reluctant to implement EHRs due to financial constraints, usability concerns, and apprehension about unintended consequences, including the introduction of medical errors related to EHR use. The goal of this study was to characterize and describe physicians' attitudes towards three consequences of EHR implementation: (1) the potential for EHRs to introduce new errors; (2) improvements in healthcare quality; and (3) changes in overall physician satisfaction.

Ambulatory prescribing errors among community-based providers in two states.

Objective: Little is known about the frequency and types of prescribing errors in the ambulatory setting among community-based, primary care providers. Therefore, the rates and types of prescribing errors were assessed among community-based, primary care providers in two states.

Material And Methods: A non-randomized cross-sectional study was conducted of 48 providers in New York and 30 providers in Massachusetts, all of whom used paper prescriptions, from September 2005 to November 2006.

Massachusetts e-Health Project increased physicians' ability to use registries, and signals progress toward better care.

The ability to generate and use registries--lists of patients with specific conditions, medications, or test results--is considered a measure of physicians' engagement with electronic health record systems and a proxy for high-quality health care. We conducted a pre-post survey of registry capability among physicians participating in the Massachusetts eHealth Collaborative, a four-year, $50 million health information technology program. Physicians who participated in the program increased their ability to generate some types of registries--specifically, for laboratory results and medication use.

Relationship between use of electronic health record features and health care quality: results of a statewide survey.

Background: Electronic health records (EHRs) are widely viewed as useful tools for supporting the provision of high quality healthcare. However, evidence regarding their effectiveness for this purpose is mixed, and existing studies have generally considered EHR usage a binary factor and have not considered the availability and use of specific EHR features.

Objective: To assess the relationship between the use of an EHR and the use of specific EHR features with quality of care.

Physician attitudes toward health information exchange: results of a statewide survey.

Objective: To assess physicians' attitudes toward health information exchange (HIE) and physicians' willingness to pay to participate in HIE.

Design: We conducted a cross-sectional mail survey of 1296 licensed physicians (77% response rate) in Massachusetts in 2007.

Measurements: Perceptions of the potential effects of HIE on healthcare costs, quality of care, clinicians' time, patients' privacy concerns, and willingness to pay for HIE.

Ability to generate patient registries among practices with and without electronic health records.

Background: The ability to generate registries of patients with particular clinical attributes, such as diagnoses or medications taken, is central to measuring and improving the quality of health care. However, it is not known how many providers have the ability to generate such registries.

Objectives: To assess the proportion of physician practices that can construct registries of patients with specific diagnoses, laboratory results, or medications, and to determine the relationship between electronic health record (EHR) usage and the ability to perform registry functions.

Imminent adopters of electronic health records in ambulatory care.

Background: Although evidence suggests electronic health records (EHRs) can improve quality and efficiency, provider adoption rates in the US ambulatory setting are relatively low. Prior studies have identified factors correlated with EHR use, but less is known about characteristics of physicians on the verge of adoption.

Objective: To compare characteristics of physicians who are imminent adopters of EHRs with EHR users and non-users.

The relationship between electronic health record use and quality of care over time.

OBJECTIVE Electronic health records (EHRs) have the potential to advance the quality of care, but studies have shown mixed results. The authors sought to examine the extent of EHR usage and how the quality of care delivered in ambulatory care practices varied according to duration of EHR availability. METHODS The study linked two data sources: a statewide survey of physicians' adoption and use of EHR and claims data reflecting quality of care as indicated by physicians' performance on widely used quality measures.

Electronic health records and malpractice claims in office practice.

Background: Electronic health records (EHRs) may improve patient safety and health care quality, but the relationship between EHR adoption and settled malpractice claims is unknown.

Methods: Between June 1, 2005, and November 30, 2005, we surveyed a random sample of 1884 physicians in Massachusetts to assess availability and use of EHR functions, predictors of use, and perceptions of medical practice. Information on paid malpractice claims was accessed on the Massachusetts Board of Registration in Medicine (BRM) Web site in April 2007.

Ability to perform registry functions among practices with and without electronic health records.

Patient care registries allow physicians to identify patients based on a subset of conditions, including medicine prescribed, laboratory results and diagnosis. The presence of EHRs and a physician's ability to query across patient medical records is unknown in Massachusetts. A survey was conducted to examine the presence of EHRs in medical practices, and the degree to which EHRs enable physicians to carry out registry functions.

Electronic health records: use, barriers and satisfaction among physicians who care for black and Hispanic patients.

Objectives: Electronic health records (EHRs) are a promising tool to improve the quality of health care, although it remains unclear who will benefit from this new technology. Given that a small group of providers care for most racial/ethnic minorities, we sought to determine whether minority-serving providers adopt EHR systems at comparable rates to other providers.

Methods: We used survey data from stratified random sample of all medical practices in Massachusetts in 2005.

Readiness for electronic health records: comparison of characteristics of practices in a collaborative with the remainder of Massachusetts.

Objective: The Massachusetts e-Health Collaborative (MAeHC) is implementing electronic health records (EHRs) in physicians' offices throughout three diverse communities. This study's objective was to assess the degree to which these practices are representative of physicians' practices statewide.

Design: We surveyed all MAeHC physicians (n=464) and compared their responses to those of a contemporaneously surveyed statewide random sample (n=1884).

Electronic health records: which practices have them, and how are clinicians using them?

Background: Limited data exist to estimate the use of electronic health records (EHRs) in ambulatory care practices in the United States.

Methods: We surveyed a stratified random sample of 1829 office practices in Massachusetts in 2005. The one-page survey measured use of health information technology, plans for EHR adoption and perceived barriers to adoption.

Physicians and electronic health records: a statewide survey.

Background: Electronic health records (EHRs) allow for a variety of functions, ranging from visit documentation to laboratory test ordering, but little is known about physicians' actual use of these functions.

Methods: We surveyed a random sample of 1884 physicians in Massachusetts by mail and assessed availability and use of EHR functions, predictors of use, and the relationships between EHR use and physicians' perceptions of medical practice.

Results: A total of 1345 physicians responded to the survey (71.

Correlates of electronic health record adoption in office practices: a statewide survey.

Objective: Despite emerging evidence that electronic health records (EHRs) can improve the efficiency and quality of medical care, most physicians in office practice in the United States do not currently use an EHR. We sought to measure the correlates of EHR adoption.

Design: Mailed survey to a stratified random sample of all medical practices in Massachusetts in 2005, with one physician per practice randomly selected for survey.