Electronic Medical Records in Solo/Small Groups: A Qualitative Study of Physician User Types

Background. There is growing recognition that physician use of electronic medical records (EMRs) is critical for improving quality of care in outpatient settings. Methods: We interviewed EMR physician champions from 20 solo/small group practices to understand different types of EMR users and their EMR-related costs and benefits. Results: Interviewees differed greatly in the EMR-related benefits they generated. These differences were associated with how they used the EMR, and the amount of effort they invested in making changes to complement EMR use. We defined five types of physician EMR users: Viewers, Basic Users, Strivers, Arrivers, and System Changers. The majority of interviewees were Strivers and Arrivers, physicians who have already invested substantial time in numerous process changes that help generate EMR-related benefits. Conclusions: Incentives and comprehensive support services for facilitating complementary process changes could be important for moving physicians from one user group to another. Additional research is needed to verify this user typology and to further define the relationship between user types and EMR-generated financial and quality benefits.