• 1. Hornof WJ, Brentson PR, Self JA, et al. Development of a complete electronic medical record in an academic institution. J Am Vet Med Assoc 2001; 218: 17711775.

    • Search Google Scholar
    • Export Citation
  • 2. McCullough JS, Casey M, Moscovice I, et al. The effect of health information technology on quality in US hospitals. Health Aff (Millwood) 2010; 29: 647654.

    • Search Google Scholar
    • Export Citation
  • 3. Matushek KJ, Audin JH. A new classification for retrospective reviews of medical records. J Am Vet Med Assoc 2008; 232: 6.

  • 4. Lorenzi NM, Kouroubali A, Detmer DE, et al. How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings. BMC Med Inform Decis Mak [serial online] 2009; 9: 15. Available at: www.biomedcentral.com/1472-6947/9/15. Accessed Aug 1, 2013.

    • Search Google Scholar
    • Export Citation
  • 5. Thakkar M, Davis DC. Risks, barriers, and benefits of EHR systems: a comparative study based on size of hospital. Perspect Health Inf Manag [serial online] 2006; 3: 5. Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC2047303/. Accessed Aug 1, 2013.

    • Search Google Scholar
    • Export Citation
  • 6. Zandieh SO, Yoon-Flannery K, Kuperman GJ, et al. Challenges to EHR implementation in electronic versus paper-based office practices. J Gen Intern Med 2008; 23: 755761.

    • Search Google Scholar
    • Export Citation
  • 7. Jamoom E, Beatty P, Bercovitz A, et al. Physician adoption of electronic health record systems: United States, 2011. NCHS data brief No. 98. Hyattsville, Md: National Center for Health Statistics, 2012.

    • Search Google Scholar
    • Export Citation
  • 8. Hsiao C-J, Hing D. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001)2013. NCHS data brief No. 143. Hyattsville, Md: National Center for Health Statistics, 2014.

    • Search Google Scholar
    • Export Citation
  • 9. McCurdy HD. The paperless practice. J Am Vet Med Assoc 2001; 218: 17761777.

  • 10. Pollari FL, Bonnett BN, Allen DG, et al. Quality of computerized medical record abstract data at a veterinary teaching hospital. Prev Vet Med 1996; 27: 141154.

    • Search Google Scholar
    • Export Citation
  • 11. Simon SR, Kaushal R, Cleary PD, et al. Correlates of electronic health record adoption in office practices: a statewide survey. J Am Med Inform Assoc 2007; 14: 110117.

    • Search Google Scholar
    • Export Citation
  • 12. Goldschmidt PG. HIT and MIS: Implications of Health Information Technology and Medical Information Systems. Communications of the ACM 2005; 48: 6974.

    • Search Google Scholar
    • Export Citation
  • 13. Smith-Akin KA, Bearden CF, Pittenger ST, et al. Toward a veterinary informatics research agenda: an analysis of the PubMedindexed literature. Int J Med Inform 2007; 76: 306312.

    • Search Google Scholar
    • Export Citation
  • 14. Zaninelli M, Tangorra FM, Castano S, et al. The O3-vet project: a veterinary electronic patient record based on the web technology and the ADT-IHE actor for veterinary hospitals. Comput Methods Programs Biomed 2007; 87: 6877.

    • Search Google Scholar
    • Export Citation
  • 15. Brailer DJ, Terasawa EL. Use and adoption of computer-based patient records. Oakland, Calif: California HealthCare Foundation, 2003.

  • 16. Crowe DC. An appeal for better automated medical records. J Am Vet Med Assoc 2003; 223: 15661567.

  • 17. Committee on Data Standards for Patient Safety Board on Health Care Services. Key capabilities of an Electronic Health Record system (Lett Rep). Washington, DC: Institute of Medicine, 2003.

    • Search Google Scholar
    • Export Citation
  • 18. Day MJ, Breitschwerdt E, Cleaveland S, et al. Surveillance of zoonotic infectious diseases transmitted by small companion animals. Emerg Infect Dis [serial online] 2012; 18. Available at: dx.doi.org/10.3201/eid1812.120664. Accessed Jul 26, 2013.

    • Search Google Scholar
    • Export Citation
  • 19. Taylor LH, Latham SM, Woolhouse ME. Risk factors for human disease emergence. Philos Trans R Soc Lond B Biol Sci 2001; 345: 983989.

  • 20. Woolhouse MEJ, Gowtage-Sequeria S. Host range and emerging and reemerging pathogens. Emerg Inf Dis 2005; 11: 18421847.

  • 21. Jones KE, Patel NG, Levy MA, et al. Global trends in emerging infectious diseases. Nature 2008; 451: 990993.

  • 22. Glickman LT, Moore GE, Glickman NW, et al. Purdue University)Banfield national companion animal surveillance program for emerging and zoonotic diseases. Vector Borne Zoonotic Dis 2006; 6: 1423.

    • Search Google Scholar
    • Export Citation
  • 23. Peterson A, Suchman A, Newman D, et al. Evaluation of potential data sources for animal drugs used in veterinary medicine. Rockville, Md: FDA, 2010.

    • Search Google Scholar
    • Export Citation
  • 24. Moore GE, Ward MP, Kulldorff M, et al. A space-time cluster of adverse events associated with canine rabies vaccine. Vaccine 2005; 23: 55575562.

    • Search Google Scholar
    • Export Citation
  • 25. Smith K, Martinez A, Craddolph R, et al. An integrated cattle health monitoring system. Conf Proc IEEE Eng Med Biol Soc 2006; 1: 46594662.

    • Search Google Scholar
    • Export Citation
  • 26. Fahey J. U.S. power grid costs rise, but service slips. Associated Press 2013; Mar 5. Available at: www.bigstory.ap.org/article/us-power-grid-costs-rise-service-slips. Accessed Aug 1, 2013.

    • Search Google Scholar
    • Export Citation
  • 27. Massoud A. U.S. electrical grid gets less reliable as outages increase and R&D decreases. University of Minnesota College of Science & Engineering page 2011;Feb 22. Available at: tli.umn.edu/blog/security-technology/u-s-electrical-grid-gets-less-reliable-as-outages-increase-and-rd-decreases/. Accessed Aug 1, 2013.

    • Search Google Scholar
    • Export Citation
  • 28. Bernardo TM, Malinowski RP. Progress in the capture, manipulation, and delivery of medical media and its impact on education, clinical care, and research. J Vet Med Educ 2005; 32: 2130.

    • Search Google Scholar
    • Export Citation
  • 29. Wright MA, Balance D, Robertson ID, et al. Introduction to DICOM for the practicing veterinarian. Vet Radiol Ultrasound 2008; 49 (suppl 1):S14S18.

    • Search Google Scholar
    • Export Citation
  • 30. Santamaria SL, Zimmerman KL. Uses of informatics to solve real world problems in veterinary medicine. J Vet Med Educ 2011; 38: 103109.

    • Search Google Scholar
    • Export Citation

Survey of electronic veterinary medical record adoption and use by independent small animal veterinary medical practices in Massachusetts

Lauren M. Krone DVM, MPH1, Catherine M. Brown DVM, MS, MPH2, and Joann M. Lindenmayer DVM, MPH3
View More View Less
  • 1 Department of Environmental and Population Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 2 Division of Epidemiology and Immunization, State Laboratory Institute, Massachusetts Department of Public Health, 305 South St, Jamaica Plain, MA 02130.
  • | 3 Department of Environmental and Population Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Abstract

Objective—To estimate the proportion of independent small animal veterinary medical practices in Massachusetts that use electronic veterinary medical records (EVMRs), determine the purposes for which EVMRs are used, and identify perceived barriers to their use.

Design—Survey.

Sample—100 veterinarians.

Procedures—213 of 517 independent small animal veterinary practices operating in Massachusetts were randomly chosen for study recruitment. One veterinarian at each practice was invited by telephone to answer a hardcopy survey regarding practice demographics, medical records type (electronic, paper, or both), purposes of EVMR use, and perceived barriers to adoption. Surveys were mailed to the first 100 veterinarians who agreed to participate. Practices were categorized by record type and size (large [≥ 5 veterinarians], medium [3 to 4 veterinarians], or small [1 to 2 veterinarians]).

Results—84 surveys were returned; overall response was 84 of 213 (39.4%). The EVMRs were used alone or together with paper records in 66 of 82 (80.5%) practices. Large and medium-sized practices were significantly more likely to use EVMRs combined with paper records than were small practices. The EVMRs were most commonly used for ensuring billing, automating reminders, providing cost estimates, scheduling, recording medical and surgical information, and tracking patient health. Least common uses were identifying emerging infectious diseases, research, and insurance. Eleven veterinarians in paper record–only practices indicated reluctance to change, anticipated technological problems, time constraints, and cost were barriers to EVMR use.

Conclusions and Clinical Relevance—Results indicated EVMRs were underutilized as a tool for tracking and improving population health and identifying emerging infectious diseases. Efforts to facilitate adoption of EVMRs for these purposes should be strengthened by the veterinary medical, human health, and public health professions.

Abstract

Objective—To estimate the proportion of independent small animal veterinary medical practices in Massachusetts that use electronic veterinary medical records (EVMRs), determine the purposes for which EVMRs are used, and identify perceived barriers to their use.

Design—Survey.

Sample—100 veterinarians.

Procedures—213 of 517 independent small animal veterinary practices operating in Massachusetts were randomly chosen for study recruitment. One veterinarian at each practice was invited by telephone to answer a hardcopy survey regarding practice demographics, medical records type (electronic, paper, or both), purposes of EVMR use, and perceived barriers to adoption. Surveys were mailed to the first 100 veterinarians who agreed to participate. Practices were categorized by record type and size (large [≥ 5 veterinarians], medium [3 to 4 veterinarians], or small [1 to 2 veterinarians]).

Results—84 surveys were returned; overall response was 84 of 213 (39.4%). The EVMRs were used alone or together with paper records in 66 of 82 (80.5%) practices. Large and medium-sized practices were significantly more likely to use EVMRs combined with paper records than were small practices. The EVMRs were most commonly used for ensuring billing, automating reminders, providing cost estimates, scheduling, recording medical and surgical information, and tracking patient health. Least common uses were identifying emerging infectious diseases, research, and insurance. Eleven veterinarians in paper record–only practices indicated reluctance to change, anticipated technological problems, time constraints, and cost were barriers to EVMR use.

Conclusions and Clinical Relevance—Results indicated EVMRs were underutilized as a tool for tracking and improving population health and identifying emerging infectious diseases. Efforts to facilitate adoption of EVMRs for these purposes should be strengthened by the veterinary medical, human health, and public health professions.

Contributor Notes

Dr. Krone's present address is Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Dr. Lindenmayer's present address is Humane Society International, 2100 L St, NW, Washington, DC 20037.

Dr. Krone was a fourth-year veterinary medical student at the time of the study.

Supported in part by NIH Short-Term Research Training Grant RR029724.

Address correspondence to Dr. Lindenmayer (Joann.Lindenmayer@tufts.edu).