EHR adoption among ambulatory care teams.

Objectives: This study provides information on the types of practices that employ 2 types of advance practice providers (APPs), nurse practitioners (NPs) and physician assistants (PAs), and the association between employment of APPs and health information technology (IT) adoption by the practice. Study Design: Three outcomes predicted the likelihood that practices employed at least 1 NP, at least 1 PA, or at least 1 of either type of APP; one outcome estimated electronic health record (EHR) adoption across practices; and 4 models assessed the EHR functionalities used by practices. Methods: Data from SK&A Information Services' 2013 Office-Based Provider Database were used to estimate EHR adoption using a Poisson regression model. Independent variables included practice size, care setting, practice specialty, ownership, geographic region, whether a practice employed a NP, and whether a practice employed a PA. Results: In 2013, three-fourths of practices that employed at least 1 APP had adopted an EHR. Practices that employed at least 1 APP were 9% to 12% more likely to have an EHR that had advanced functionalities, compared with practices without an APP. Conclusions: This study found an association between employment of APP staff and practice-level adoption of EHRs and practice-level adoption of certain EHR functionalities. Practices that employ APPs are prepared to implement team-based approaches to care that may be further enhanced through the use of health IT. Future research should examine how practices with APPs are using health IT to promote better health and coordinate care.