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05/13/2013

2013 U.S. Physician Study: understanding the questions behind the answers


In late May, the Deloitte Center for Health Solutions published our annual report, based on our Survey of U.S. Physicians, in which we examined a broad range of issues from the respondents’ view of health care reform to the future of the practice of medicine. Much of the report focused on adoption (or the lack thereof) of health information technology (IT). Moments after its release, calls started coming in with questions about the results.

Interestingly, some common threads ran through those questions. While they may not qualify as an official FAQ for the survey and its results, many may find themselves asking some of the same questions:

  1. Why do your results show a lower, higher, or different rate of adoption of IT compared with other surveys and research? One of the most important challenges to interpreting answers is to understand the questions that lie behind them. Ambiguous surveys can lead to ambiguous results—we took great care to be specific in our inquiry. Rather than ask whether or not a physician was using an electronic health record (EHR), which often leads to overestimation of EHR adoption, we made the criteria those who meet Stage 1 of Meaningful Use. In addition, we use a sampling methodology that weights the answers to reflect the distribution of doctors across years in practice, gender, region, and medical specialty.
  2. Why do you show relatively low levels of use of mHealth adoption? Again, the answer you get depends on the question you ask. If you ask me if I own a smartphone, I’ll say yes. I don’t own one because I’m a doctor but rather because of other demographic and socio-economic factors. To assume because I’m a doctor that I use my smartphone in my clinical practice would simply be wrong. We wanted to understand how physicians were using these advanced devices as part of clinical care to access medical records, prescribe medication, etc.; therefore, we asked questions specifically related to such usage. Of course, back in 1990 when I was a resident, I had a bag phone plugged into the cigarette lighter of my old car for when my beeper went off and I was on call. Does that make me an early adopter of mHealth?
  3. What does it all mean? This is one of my favorite questions, since it implies that there is a secret message in the data that perhaps we haven’t shared. To this I say that, while the growth in IT adoption isn’t surprising, two important factors are appearing:
  • The drivers to adopt are expanding well beyond Meaningful Use. As the nation moves toward value-based reimbursement and connectivity, having a strong foundation of IT becomes essential. Even the strongest of curmudgeons who is determined not to adopt technology sees this shift as inevitable.
  • The 2013 Survey of U.S. Physicians saw a gap between adopters and non-adopters, particularly in the types of services they offer to consumers. Access to test results, self-scheduling, messaging, and other conveniences distinguish the adopters from their non-adopting counterparts. While these may seem relatively trivial, some patients may form their judgments on quality of care based upon their service experience.

Keeping track of the nation’s march toward a data-driven, value-based healthcare system may require a deep understanding of the views of its stakeholders. And, as always, to understand the answers, you have to understand the questions.

by Harry Greenspun, MD, Senior Advisor

Deloitte Center for Health Solutions

Harry Greenspun, MD, SeniorAdvisor, Deloitte Center for Health Solutions

Harry Greenspun, M.D. is the senior advisor for health care technology and transformation at the Deloitte Center for Health Solutions. He has held a diverse range of clinical and executive roles across the health care industry, giving him a unique perspective on current and future challenges.

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