Last month, I reported on preliminary findings from Healthgrades and HIMSS Analytics showing that more sophisticated deployments of electronic medical records had a statistically significant impact on patient outcomes in U.S. hospitals. Since then, I've come across a number of other studies that also purport to demonstrate positive outcomes from EMRs in patient health.

For instance, two studies of patients with diabetes  – one in 2012 and the other in 2013 – established positive outcomes with the use of outpatient electronic medical records. And other recent studies have established significant connections between EMRs and lower hospitalization costs, process improvements, and improvements on certain quality measures.

It must be a great time to be a clinical user of EMRs, right? Not according to a 2013 study commissioned by the American Medical Association and conducted by the RAND Corporation. That study found that EMRs are one of the most significant causes of physician dissatisfaction.

My colleague, Mike Milliard, captured the essence of that study, writing, "While physicians recognize the benefits of electronic health records, they also complain that many systems deployed nowadays are cumbersome to use and often act as obstacles to quality care."

These aren't technology Luddites, either. 

"Some patients mentioned that I often spent more time typing on a computer instead of talking to them," Kevin Pho, a popular physician-blogger who is very tech-savvy, wrote in USA Today earlier this year. "Now I leave my laptop outside the exam room…Today's systems too often obstruct medical care, and threaten to monopolize providers' time at the expense of talking to patients."

It's a conundrum that bears a lot more investigation: How do you implement technological solutions with demonstrable benefits that a significant population of its users seems to despise?

There are two natural responses to this. One is to identify beneficial IT solutions that buck the trend – ones that physicians, as a group, like – and attempt to replicate the user experience. The other is to see if there are certain cohorts of physicians who are more likely to dislike the technology, and work with them on using those IT solutions in less obstructive ways.

There's an interesting study in "pre-press" with the American Journal of Medicine that may help address both approaches. "Perceptions of Electronic Health Record Implementation: A Statewide Survey of Physicians in Rhode Island," by Matthew C. Wylie, MD, Rosa R. Baier, MPH, and Rebekah L. Gardner, MD, is a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey, 2009 to 2013.

According to the article's abstract, the researchers found:

Most providers think that electronic health record use improves billing and quality improvement, but has not improved job satisfaction. 

Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P < .001). 

Older physician age is associated with worse opinion of electronic health record introduction (P < .001).

Of the 18 electronic health record vendors most frequently used in Rhode Island, five were associated with improved job satisfaction.

Rhode Island is an interesting region for such a study. It was among the first states to set up a statewide data exchange, was an early supporter of electronic prescribing and more than four out of every five physicians now describe themselves as regular EMR users. The study used the state's licensure data to attempt to survey every practicing physician in the state, and achieved a 62 percent response rate

Readers here would not be surprised by the finding that older physician age is associated with more negative views of EMRs – fair or not, conventional wisdom has long held that younger physicians, who have more favorable views of technology in general and who have been exposed to health IT during their training, are more likely to adopt technology than the cohort of physicians who have a long, established practice grounded in paper solutions.

I particularly liked the way the study operationalized a variable measuring physician involvement with technology. The researchers designed a composite score that took into consideration if the physician used IT for electronic prescribing, progress notes and problem lists, drug interaction warnings, continuity of care documents and other summaries.

The good news for health IT evangelists is that physician familiarity with EMRs and other digital tools doesn't breed contempt, but actually leads to improved satisfaction with their medical practice as a whole. Following on the heels of a related study in Florida, the Rhode Island study revealed "that physicians satisfied with their information technology were four times more likely to be satisfied with their current state of medical practice" than physicians who were unhappy with IT.

The authors who shared their study with me have requested that I not reproduce all their findings until the article is published. I'll be more than happy to report on more of the team's findings – especially their data on physician satisfaction by vendor – this fall.

Jack Beaudoin was a co-founder of Healthcare IT News and its first editor. From 2003 to 2013 he served as president and CEO of MedTech Media, overseeing the transition to HIMSS Media.