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J Eval Clin Pract. 2014 Feb;20(1):36-42. doi: 10.1111/jep.12076. Epub 2013 Aug 20.

The good, the bad and the early adopters: providers' attitudes about a common, commercial EHR.

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  • 1Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.



To describe primary care providers' (PCP) attitudes about the impact of a mature, commercial electronic health records (EHR) on clinical practice in settings with experience using the system and to evaluate whether a provider's propensity to adopt new technologies is associated with more favourable perceptions.


We surveyed PCPs in 11 practices affiliated with three health systems in Texas. Most practices had greater than 5 years of experience with the Epic EHR. The effect of early adopter of technology status was evaluated using logistic regression.


One hundred forty-six PCPs responded (70%). Most thought the EHR had a positive impact on routine tasks, such as prescription refills (94%), whereas fewer agreed for complex tasks, such as delivery of guideline-concordant care for chronic illnesses (51%). Two-thirds (62%) thought it interfered with eye contact with patients, and 40% reported that it interfered with in-visit communication. Early adopters of technology reported greater positive effects of the EHR, even after adjusting for age, ranging from 2% to 15% higher on satisfaction ratings.


PCPs practicing in settings with considerable experience using a common commercial EHR identified many positive effects, as well as two key areas for improvement - patient centredness and intelligent decision support. Providers with a propensity to adopt new technologies have more favourable perceptions of the EHR.

© 2013 John Wiley & Sons, Ltd.


attitude of health personnel; attitude to computers; early adopter; electronic health record; physicians; primary care; primary health care

[PubMed - indexed for MEDLINE]
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