The relationship between the external environment and physician e-mail communication: The mediating role of health information technology availability

Olena Mazurenko, Larry R. Hearld, Nir Menachemi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician's external environment may contribute to such variations by enabling or constraining a physician's ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication. Purpose: The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice's HIT availability. Methodology: The data were obtained from the Health Tracking Physician Survey (2008) and the Area Resource File (2008). Cross-sectional multivariable subgroup path analysis was used to investigate the mediating role of HIT availability across 2,850 U.S. physicians. Findings: Solo physicians' perceptions about malpractice were associated with 0.97 lower odds (p <.05) of e-mail communication with patients and other providers, as compared to group and hospital practices, even when mediated by HIT availability. Subgroup analyses indicated that different types of practices are responsive to the different dimensions of the external environment. Specifically, solo practitioners were more responsive to the availability of resources in their environment, with per capita income associated with lower likelihood of physician e-mail communication (OR = 0.99, p <.01). In contrast, physicians working in the group practices were more responsive to the complexity of their environment, with a physician's perception of practicing in environments with higher malpractice risks associated with greater information technology availability, which in turn was associated with a greater likelihood of communicating via e-mail with patients (OR = 1.02, p <.05) and other physicians (OR = 1.03, p <.001). Practical Applications: The association between physician e-mail communication and the external environment is mediated by the practice's HIT availability. Efforts to improve physician e-mail communication and HIT adoption may need to reflect the varied perceptions of different types of practices.

Original languageEnglish (US)
Pages (from-to)122-131
Number of pages10
JournalHealth Care Management Review
Volume42
Issue number2
DOIs
StatePublished - Apr 1 2017

Fingerprint

Medical Informatics
Postal Service
Communication
Physicians
Malpractice
External environment
Electronic mail
Health information technology
Group Practice Hospitals
Group Practice
Aptitude

Keywords

  • external environment
  • health information technology
  • mediation analysis
  • physicians' communication

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Strategy and Management

Cite this

@article{331ca40470864744ad5bafc0d66c6423,
title = "The relationship between the external environment and physician e-mail communication: The mediating role of health information technology availability",
abstract = "Background: Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician's external environment may contribute to such variations by enabling or constraining a physician's ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication. Purpose: The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice's HIT availability. Methodology: The data were obtained from the Health Tracking Physician Survey (2008) and the Area Resource File (2008). Cross-sectional multivariable subgroup path analysis was used to investigate the mediating role of HIT availability across 2,850 U.S. physicians. Findings: Solo physicians' perceptions about malpractice were associated with 0.97 lower odds (p <.05) of e-mail communication with patients and other providers, as compared to group and hospital practices, even when mediated by HIT availability. Subgroup analyses indicated that different types of practices are responsive to the different dimensions of the external environment. Specifically, solo practitioners were more responsive to the availability of resources in their environment, with per capita income associated with lower likelihood of physician e-mail communication (OR = 0.99, p <.01). In contrast, physicians working in the group practices were more responsive to the complexity of their environment, with a physician's perception of practicing in environments with higher malpractice risks associated with greater information technology availability, which in turn was associated with a greater likelihood of communicating via e-mail with patients (OR = 1.02, p <.05) and other physicians (OR = 1.03, p <.001). Practical Applications: The association between physician e-mail communication and the external environment is mediated by the practice's HIT availability. Efforts to improve physician e-mail communication and HIT adoption may need to reflect the varied perceptions of different types of practices.",
keywords = "external environment, health information technology, mediation analysis, physicians' communication",
author = "Olena Mazurenko and Hearld, {Larry R.} and Nir Menachemi",
year = "2017",
month = "4",
day = "1",
doi = "10.1097/HMR.0000000000000095",
language = "English (US)",
volume = "42",
pages = "122--131",
journal = "Health Care Management Review",
issn = "0361-6274",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The relationship between the external environment and physician e-mail communication

T2 - The mediating role of health information technology availability

AU - Mazurenko, Olena

AU - Hearld, Larry R.

AU - Menachemi, Nir

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background: Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician's external environment may contribute to such variations by enabling or constraining a physician's ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication. Purpose: The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice's HIT availability. Methodology: The data were obtained from the Health Tracking Physician Survey (2008) and the Area Resource File (2008). Cross-sectional multivariable subgroup path analysis was used to investigate the mediating role of HIT availability across 2,850 U.S. physicians. Findings: Solo physicians' perceptions about malpractice were associated with 0.97 lower odds (p <.05) of e-mail communication with patients and other providers, as compared to group and hospital practices, even when mediated by HIT availability. Subgroup analyses indicated that different types of practices are responsive to the different dimensions of the external environment. Specifically, solo practitioners were more responsive to the availability of resources in their environment, with per capita income associated with lower likelihood of physician e-mail communication (OR = 0.99, p <.01). In contrast, physicians working in the group practices were more responsive to the complexity of their environment, with a physician's perception of practicing in environments with higher malpractice risks associated with greater information technology availability, which in turn was associated with a greater likelihood of communicating via e-mail with patients (OR = 1.02, p <.05) and other physicians (OR = 1.03, p <.001). Practical Applications: The association between physician e-mail communication and the external environment is mediated by the practice's HIT availability. Efforts to improve physician e-mail communication and HIT adoption may need to reflect the varied perceptions of different types of practices.

AB - Background: Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician's external environment may contribute to such variations by enabling or constraining a physician's ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication. Purpose: The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice's HIT availability. Methodology: The data were obtained from the Health Tracking Physician Survey (2008) and the Area Resource File (2008). Cross-sectional multivariable subgroup path analysis was used to investigate the mediating role of HIT availability across 2,850 U.S. physicians. Findings: Solo physicians' perceptions about malpractice were associated with 0.97 lower odds (p <.05) of e-mail communication with patients and other providers, as compared to group and hospital practices, even when mediated by HIT availability. Subgroup analyses indicated that different types of practices are responsive to the different dimensions of the external environment. Specifically, solo practitioners were more responsive to the availability of resources in their environment, with per capita income associated with lower likelihood of physician e-mail communication (OR = 0.99, p <.01). In contrast, physicians working in the group practices were more responsive to the complexity of their environment, with a physician's perception of practicing in environments with higher malpractice risks associated with greater information technology availability, which in turn was associated with a greater likelihood of communicating via e-mail with patients (OR = 1.02, p <.05) and other physicians (OR = 1.03, p <.001). Practical Applications: The association between physician e-mail communication and the external environment is mediated by the practice's HIT availability. Efforts to improve physician e-mail communication and HIT adoption may need to reflect the varied perceptions of different types of practices.

KW - external environment

KW - health information technology

KW - mediation analysis

KW - physicians' communication

UR - http://www.scopus.com/inward/record.url?scp=84947709417&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947709417&partnerID=8YFLogxK

U2 - 10.1097/HMR.0000000000000095

DO - 10.1097/HMR.0000000000000095

M3 - Article

C2 - 26587999

AN - SCOPUS:84947709417

VL - 42

SP - 122

EP - 131

JO - Health Care Management Review

JF - Health Care Management Review

SN - 0361-6274

IS - 2

ER -