| Background. Health IT is suggested as feasible solution for challenges faced by the U.S. health care. Perception is found as the most important determinant of IT use among physicians but empirical evidence of the effects of physicians' individual, organizational, and health care system characteristics is few.;Purpose. This study attempts to profound current knowledge about physicians' IT use and provide empirical evidence of the importance of three categories of characteristics.;Methods. This study utilized secondary data sets: 2000-2001 Community Tracking Study (CTS) Physician Survey and 1998-1999 CTS Physicians Survey. Two components were created for physicians' IT use by a principal component analysis. Three categories of influencing factors are considered; (1) physicians' personal and practice characteristics (perception of IT effectiveness, age, gender, race, income, practice ownership, specialty, and practice type), (2) organizational characteristics (provide quality care, clinical decision making authority, referral/ancillary authority, and physician compensation), and (3) health care system characteristics (HMO penetration rate, health care market competitiveness, the proportion of revenue from Medicaid, and the proportion of revenue from Medicare). Three different types of effects were assumed and tested by three regression techniques: multiple linear regression, moderated multiple regression, and multi-level linear regression.;Results. Physician perception of IT effectiveness was found to be a strong determinant of IT use. Referral/ancillary authority, HMO penetration were found to be directly associated with IT use. Variations in the relationship between physician perception of IT effectiveness and IT use were found (by income, practice types, referral/ancillary authority, productivity measures). The impacts of physician perception of IT effectiveness for data communication vary across the CTS communities and a weaker impact of perception of IT effectiveness on IT use for data communication purposes was found among communities with higher market competition. The random impact of perception of IT effectiveness for patent care was not found.;Conclusions. Organizational and health care system characteristics, as well as physician perception, affects physicians' IT use. The impacts of physician perception can be affected by personal and practice characteristics, organizational characteristics, and health care system characteristics. IT interventions must consider external characteristics to maximize the possibility of IT success. |
