Physicians' use of email with patients: factors influencing electronic communication and adherence to best practices.

Background: With the public's increased use of the Internet, the use of email as a means of communication between patients and physicians will likely increase. Yet, despite evidence of increased interest by patients, e-mail use by physicians for clinical care has been slow.

Objective: To examine the factors associated with physician-patient e-mail, and report on the physicians' adherence to recognized guidelines for e-mail communication.

Are community health centers prepared for bioterrorism?

Community health centers (CHCs) are essential in the delivery of primary care services to underserved populations. Given the critical function of CHCs, surprisingly little is known about their role in preparing for or responding to acts of terrorism. This survey-based study examines the state of CHCs in terrorism preparedness and assesses their training needs.

Hospital information technology and positive financial performance: a different approach to finding an ROI.

This empirical study examined the relationship between information technology (IT) utilization and hospital financial performance. Using primary and secondary data, we specified and tested a series of regression models that examined this relationship in Florida hospitals. In addition, we employed performance group analysis for a select group of operational performance indicators.

Continuing decline in service delivery for family physicians: is the malpractice crisis playing a role?

Purpose: This study was conducted to monitor trends in the reduction and elimination of services offered by family physicians. In addition, we examined whether the malpractice situation may be influencing these trends.

Methods: We surveyed all family physicians in rural Florida and an equal number of randomly selected, urban, family physicians in the state.

Diffusion of information technology supporting the Institute of Medicine's quality chasm care aims.

This article examines the degree to which healthcare information technology (HIT) supporting the Institute of Medicine's (IOM) six care aims is utilized in the hospital setting and explores organizational factors associated with HIT use. Guided by the IOM's Crossing the quality chasm report and associated literature, 27 applications and/or capabilities are classified according to one or more of the six care aims. A structured survey of Florida hospitals identified the use of HIT.

Structure and functions of state public health agencies.

Objectives: We assessed the structure and functions of state health departments throughout the United States and compared our findings with those from a previous national assessment conducted in 1990.

Methods: In 2001, we sent a survey to the state health officers of all 50 states. The survey asked about the structure and functions of the state health agency.

Predicting the adoption of electronic health records by physicians: when will health care be paperless?

Objectives: The purpose of this study was threefold. First, we gathered and synthesized the historic literature regarding electronic health record (EHR) adoption rates among physicians in small practices (ten or fewer members). Next, we constructed models to project estimated future EHR adoption trends and timelines.

Availability of physician services in Florida, revisited: the effect of the professional liability insurance market on access to health care.

Background: Access to care remains a key part of improving health care outcomes in the United States. Recent reports have suggested that the number of physicians able to meet the demands for access to care may be decreasing.

Methods: We surveyed physicians practicing in rural and urban/suburban areas of Florida in 2004 to determine whether changes were occurring in health care service delivery.

Information technologies in Florida's rural hospitals: does system affiliation matter?

Context: The recent explosive growth of information technology in hospitals promises to improve hospital and patient outcomes. Financial barriers may cause rural hospitals to lag in adoption of information technology, however, formal studies that examine rural hospital adoption of information technology are lacking.

Purpose: To determine the extent to which rural Florida hospitals utilize clinical and other information technology applications, to identify related information technology issues and barriers, and to explore differences between stand-alone and system-affiliated hospitals.

Rural physicians' attitudes toward the elderly: evidence of ageism?

Rural elderly patients receive health services primarily in the outpatient setting, with their primary care provider often serving as their only point of contact with the health care system. Little is known however about the attitudes of physicians, and more specifically attitudes of those practicing in rural locations, toward differing age groups of the elderly. The current study was undertaken to examine the perceptions and attitudes of rural Florida physicians who routinely provide care for the elderly.

Perceptions of medical errors by internal medicine residents: development and validation of a new scale.

Efforts to identify the underlying structure of 40 survey items dealing with perceptions of medical errors are reported on the basis of responses from 195 medical residents. Factor analysis revealed that the medical errors perceptions were represented by a 10-factor solution. The external validity of these factors was examined relative to perceptions about the cost of medical errors, the cost of errors to health care, and the need for education and interventions to address errors.

Patient safety-related information technology utilization in urban and rural hospitals.

Ongoing research has linked certain information technology applications to reduction of medical errors and improved patient outcomes. The purpose of this study was to assess both the use of patient safety-related information technologies (PSIT) in urban and rural hospitals, as well as the organizational factors which may be linked to overall PSIT adoption. Florida's 199 acute care hospitals (170 urban; 29 rural) were surveyed regarding their utilization of PSIT.

Characteristics of hospitals that outsource information system functions.

Despite the increasing trend among hospitals to outsource information system functions, little is known about these decisions in the acute-care setting. This study examined the outsourcing behavior of hospitals in Florida to determine the characteristics of hospitals that are most likely to outsource IS functions. In addition, the results provide an overview of which IS functions are most commonly outsourced in hospitals.

The changing face of access to family physician services in rural Florida.

Objectives: This study's purpose was to determine whether access to services performed by Florida family physicians in rural areas is changing and whether the recent changes in the availability or cost of professional liability insurance may be influencing service provision.

Methods: We conducted a survey of all family physicians in rural Florida, asking about changes in health care services and procedures provided, insurance coverage and premiums, satisfaction with practice, and plans for future practice.

Results: Of the 204 respondents, 96 (49.

Factors affecting the adoption of telemedicine--a multiple adopter perspective.

This paper utilizes the diffusion of innovation framework to discuss factors affecting adoption of telemedicine. Empirical and anecdotal findings are organized across five attributes affecting innovation adoption rates for the following four adopter groups: physicians, patients, hospital administrators, and payers. A discussion of the implications is included.

Adoption factors associated with patient safety-related information technology.

Information technology (IT) that positively affects both quality of care and patient safety currently exists but is not used widely. This study identifies organizational and external factors associated with the adoption of patient safety-related IT (PSIT) in acute care hospitals in Florida. Factors found to be positively correlated with PSIT use included physicians' active involvement in clinical IT planning, the placement of strategic importance on IT by the organization, CIO involvement in patient safety planning, and the perception of an adequate selection of products from vendors.

Impact of the medical professional liability insurance crisis on access to care in Florida.

Background: Almost half of the US states face serious problems with professional liability insurance (PLI). Despite this, little is known about how this crisis is affecting access to care, particularly in rural areas.

Methods: We surveyed physicians practicing in rural Florida in 2003.

Opening the black box: measuring hospital information technology capability.

Recently, health care investment in information technology (IT) has experienced a significant increase. Paralleling this increase has been an increase in IT capabilities. Despite the interest in and promises of IT in the health care setting, there is a paucity of empirical research that has attempted to define an organizational measure of IT capability.