Opioid Prescribing by Physicians With and Without Electronic Health Records

Chris Harle, Robert L. Cook, Heidi S. Kinsell, Jeffrey S. Harman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Physicians in the U.S. are adopting electronic health records (EHRs) at an unprecedented rate. However, little is known about how EHR use relates to physicians’ care decisions. Using nationally representative data, we estimated how using practice-based EHRs relates to opioid prescribing in primary care.

Methods: This study analyzed 33,090 visits to primary care physicians (PCPs) in the 2007–2010 National Ambulatory Medical Care Survey. We used logistic regression to compare opioid prescribing by PCPs with and without EHRs.

Results: Thirteen percent of all visits and 33 % of visits for chronic noncancer pain resulted in an opioid prescription. Compared to visits without EHRs, visits to physicians with EHRs had 1.38 times the odds of an opioid prescription (95 % CI, 1.22–1.56). Among visits for chronic noncancer pain, physicians with EHRs had significantly higher odds of an opioid prescription (adj. OR = 1.39; 95 % CI, 1.03–1.88). Chronic pain visits involving electronic clinical notes were also more likely to result in an opioid prescription compared to chronic pain visits without (adj. OR = 1.51; 95 % CI, 1.10–2.05). Chronic pain visits involving electronic test ordering were also more likely to result in an opioid prescription compared to chronic pain visits without (adj. OR = 1.31; 95 % CI, 1.01–1.71).

Conclusions: We found higher levels of opioid prescribing among physicians with EHRs compared to those without. These results highlight the need to better understand how using EHR systems may influence physician prescribing behavior so that EHRs can be designed to reliably guide physicians toward high quality care.

Original languageEnglish (US)
JournalJournal of Medical Systems
Volume38
Issue number11
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Electronic Health Records
Opioid Analgesics
Health
Physicians
Chronic Pain
Prescriptions
Primary Care Physicians
Health Care Surveys
Quality of Health Care
Health care
Logistics
Primary Health Care
Logistic Models

Keywords

  • Electronic clinical notes
  • Electronic health records
  • Electronic test orders
  • Opioid prescribing
  • Primary care

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Information Systems
  • Health Informatics
  • Health Information Management

Cite this

Opioid Prescribing by Physicians With and Without Electronic Health Records. / Harle, Chris; Cook, Robert L.; Kinsell, Heidi S.; Harman, Jeffrey S.

In: Journal of Medical Systems, Vol. 38, No. 11, 01.01.2014.

Research output: Contribution to journalArticle

Harle, Chris ; Cook, Robert L. ; Kinsell, Heidi S. ; Harman, Jeffrey S. / Opioid Prescribing by Physicians With and Without Electronic Health Records. In: Journal of Medical Systems. 2014 ; Vol. 38, No. 11.
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