Targeted Rural Health Primary Care Research in HIT Adoption and Scope of Use
Using a sample from a national medical practice database, stratified to assure adequate responses in more rural areas, surveys will be mailed to 5,200 primary care practices in all 50 states and the District of Columbia to assess use of various forms of HIT as well as physician perceived barriers to and facilitators of HIT adoption. The survey is adapted from other instruments already used for HIT assessments, with modifications reflecting recent recommendations for improving the quality of HIT adoption studies. Intensive follow-up will be conducted to maximize the number of physicians completing and returning the surveys. Findings will be analyzed using Rural-Urban Commuting Area (RUCA) classifications grouped into four categories (urban, large rural, small rural, and isolated) to illuminate differences between different types of rural areas, as well as between rural and urban medical practices. The study is expected to provide more precise information than is currently available on the degree to which HIT is being used, as well as interest levels and barriers to adoption among physicians who are not using the technology. It also will explore relationships between rural HIT and factors such as physician practice characteristics (including safety net providers) and community factors, such as poverty and minority population. Findings — which will be disseminated through a report, policy brief, conference presentations and journal articles — will be valuable in developing policies tailored to the circumstances of different types of rural communities. In addition, the survey instrument will be made available for future national monitoring of rural HIT adoption.
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