Electronic Medical Records: Barriers to Adoption and Diffusion

The primary goal of this paper is to explore why information technology (IT) solutions such as electronic medical records (EMR) have failed to gain a foothold in the healthcare sector. Based on a review of extant research, we propose a framework for classifying the barriers to the adoption and diffusion of EMR in the healthcare sector. We map all barriers reported in the literature onto the classification scheme to demonstrate its efficacy. We conclude by suggesting potential opportunities for applying the classification framework to research and practice.

[1]  E. Rogers,et al.  Diffusion of Innovations , 1964 .

[2]  Mark Beeson,et al.  Global Political Economy , 2004 .

[3]  William R. King,et al.  Facilitators and inhibitors for the strategic use of information technology , 1994, Inf. Manag..

[4]  K E Johnson,et al.  An analysis of trends, perceptions, and use patterns of electronic medical records among US family practice residency programs. , 2000, Family medicine.

[5]  D. Blumenthal,et al.  Federal health information policy: a case of arrested development. , 2003, Health affairs.

[6]  James H Thrall,et al.  Quality and safety revolution in health care. , 2004, Radiology.

[7]  C. Safran,et al.  Effect of computer-based alerts on the treatment and outcomes of hospitalized patients. , 1994, Archives of internal medicine.

[8]  I. Sim,et al.  Physicians' use of electronic medical records: barriers and solutions. , 2004, Health affairs.

[9]  Martin Gaynor,et al.  Change, Consolidation, and Competition in Health Care Markets , 1998, The journal of economic perspectives : a journal of the American Economic Association.

[10]  S. DeCanio,et al.  The Importance of Organizational Structure for the Adoption of Innovations , 2000 .

[11]  Julie M. Fiskio,et al.  Evaluating physician satisfaction regarding user interactions with an electronic medical record system , 1999, AMIA.

[12]  Astrid M. van Ginneken,et al.  The computerized patient record: balancing effort and benefit , 2002, Int. J. Medical Informatics.

[13]  J. Schenthal,et al.  The electronic medical record. , 1962, Bulletin of the School of Medicine.

[14]  J. E. Fisher,et al.  The digital hospital: opportunities and challenges. , 2003, Journal of healthcare information management : JHIM.

[15]  H. Davies,et al.  Implementing culture change in health care: theory and practice. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[17]  Robin C. Meili,et al.  Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. , 2005, Health affairs.

[18]  A. Taddei,et al.  Use of an electronic medical record in a department of cardiology , 2000, Computers in Cardiology 2000. Vol.27 (Cat. 00CH37163).

[19]  I. Kohane,et al.  Public standards and patients' control: how to keep electronic medical records accessible but private. , 2001, BMJ : British Medical Journal.

[20]  Richard L. Daft,et al.  Essentials of Organization Theory and Design , 2000 .

[21]  David Tucker,et al.  Electronic medical record implementation barriers encountered during implementation , 1999, AMIA.

[22]  Henry J. Lowe,et al.  The electronic medical record. A randomized trial of its impact on primary care physicians' initial management of major depression [corrected]. , 2001, Archives of internal medicine.

[23]  Everett M. Rogers,et al.  Diffusion of innovations (5. ed.) , 2003 .

[24]  Homer L. Chin,et al.  The effects of an Electronic Medical Record on patient care: clinician attitudes in a large HMO , 1998, AMIA.

[25]  Melissa M. Honour,et al.  Overcoming barriers to adopting and implementing computerized physician order entry systems in U.S. hospitals. , 2004, Health affairs.

[26]  I. Geva‐May,et al.  What Prompts Health Care Policy Change? On Political Power Contests and Reform of Health Care Systems (The Case of Canada and Israel) , 2000, Journal of health politics, policy and law.

[27]  Fred D. Davis.  Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[28]  M. Braun,et al.  Inflation and Corruption , 2000 .

[29]  D. Bates.  Physicians and ambulatory electronic health records. , 2005, Health affairs.

[30]  D. Longnecker,et al.  Future Directions for Academic Practice Plans: Thoughts on Organization and Management from Johns Hopkins University and the University of Pennsylvania , 2003, Academic medicine : journal of the Association of American Medical Colleges.

[31]  K. F. Schmitt,et al.  Financial analysis projects clear returns from electronic medical records. , 2002, Healthcare financial management : journal of the Healthcare Financial Management Association.

[32]  M J Haumschild,et al.  Pharmacy-based computer system for monitoring and reporting drug interactions. , 1987, American journal of hospital pharmacy.

[33]  Use and Adoption of Computer-b a s e d Patient Records , 2003 .

[34]  J. L. Pierce,et al.  Organization Structure, Individual Attitudes and Innovation , 1977 .

[35]  David W. Bates,et al.  Position Paper: A Proposal for Electronic Medical Records in U.S. Primary Care , 2003, J. Am. Medical Informatics Assoc..

[36]  P. Clayton,et al.  Privacy, confidentiality, and electronic medical records. , 1996, Journal of the American Medical Informatics Association : JAMIA.

[37]  Luis H. R. Alvarez,et al.  PUBLICATIONS OF THE TURKU SCHOOL OF ECONOMICS AND BUSINESS ADMINISTRATION , 2005 .

[38]  Joan S. Ash,et al.  Factors affecting the diffusion of the Computer-Based Patient Record , 1997, AMIA.

[39]  James M. Gabler,et al.  MCOs continue to search for a course to EMR developments (PDF) , 2002 .