Exploring Physician Adoption of EMRs: A Multi-Case Analysis

The adoption of new technology within healthcare has been promoted as a way to reduce costs and increase efficiencies as well as improve quality. The literature has documented a significant number of implementation failures by large groups and hospitals with access to IT skills and resources. Given the low adoption rate among physicians, the challenges facing small practices can be daunting. While financial and technical barriers have been explored at the physician level, the actual implementation challenges facing small groups have not been explored. This paper presents a qualitative three case analysis of physician groups that have employed EMRs and the pre and post adoption insights. Results show that planning was a key common variable missing; the anticipated downtime was longer than expected and the workflow disruption and maintenance costs were underestimated.

[1]  Nir Menachemi,et al.  Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient Safety Technologies , 2006, Journal of Medical Systems.

[2]  Rajiv Sabherwal,et al.  The role of trust in outsourced IS development projects , 1999, CACM.

[3]  Izak Benbasat,et al.  Electronic Data Interchange and Small Organizations: Adoption and Impact of Technology , 1995, MIS Q..

[4]  P. Ring,et al.  Developmental Processes of Cooperative Interorganizational Relationships , 1994 .

[5]  B. Uzzi,et al.  Social Structure and Competition in Interfirm Networks: The Paradox of Embeddedness , 1997 .

[6]  Madden Cw.  Excess capacity: markets regulation, and values. , 1999 .

[7]  J. Alexander,et al.  Managing hospitals in turbulent times: do organizational changes improve hospital survival? , 1999, Health services research.

[8]  Liping Liu,et al.  Emerging e-business technologies for electronic medical records , 2003 .

[9]  Gary Knotts,et al.  The Effects of Customizability and Reusability on Perceived Process and Competitive Performance of Software Firms , 1998, MIS Q..

[10]  A. Zaheer,et al.  Does Trust Matter? Exploring the Effectsof Interorganizational and Interpersonaltrust on Performance , 1998 .

[11]  Carol Stoak Saunders,et al.  Emerging Electronic Partnerships: Antecedents and Dimensions of EDI Use from the Supplier's Perspective , 1998, J. Manag. Inf. Syst..

[12]  Francis L. Jeffries,et al.  Trust and Adaptation in Relational Contracting , 2000 .

[13]  L H Friedman,et al.  The Timing of Medical Technology Acquisition: Strategic Decision Making in Turbulent Environments , 2000, Journal of healthcare management / American College of Healthcare Executives.

[14]  S. Gopalakrishnan,et al.  Patterns of generation and adoption of innovation in organizations: Contingency models of innovation attributes , 1994 .

[15]  Terry L. Huston,et al.  Security issues for implementation of e-medical records , 2001, CACM.

[16]  Detmar W. Straub,et al.  Trust and TAM in Online Shopping: An Integrated Model , 2003, MIS Q..

[17]  Ben-Tzion Karsh,et al.  Are electronic medical records associated with improved perceptions of the quality of medical records, working conditions, or quality of working life? , 2004, Behav. Inf. Technol..

[18]  Rajiv Kishore,et al.  Antecedents to the adoption of ASPS in healthcare. , 2003, Journal of healthcare information management : JHIM.

[19]  E. Rogers.  Diffusion of Innovations , 1962 .

[20]  Nava Pliskin,et al.  Is eCommerce of IT Application Services (ASP) Alive and Well , 2001 .

[21]  Ranjit Singh,et al.  Estimating impacts on safety caused by the introduction of electronic medical records in primary care. , 2004, Informatics in primary care.

[22]  Mark Keil,et al.  Why Software Projects Escalate: An Empirical Analysis and Test of Four Theoretical Models , 2000, MIS Q..

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

[24]  Detmar W. Straub,et al.  Production and Transaction Economies and IS Outsourcing: A Study of the U.S. Banking Industry , 1998, MIS Q..

[25]  G. Kurtz.  EMR confidentiality and information security. , 2003, Journal of healthcare information management : JHIM.

[26]  David L. Paul,et al.  A Field of Study of the Effect of Interpersonal Trust on Virtual Collaborative Relationship Performance , 2004, MIS Q..

[27]  David B. Meinert.  Resistance to Electronic Medical Records (EMRs): A Barrier to Improved Quality of Care , 2005 .

[28]  Jérôme Barthélemy,et al.  The Hard and Soft Sides of IT Outsourcing Management , 2003 .

[29]  S. Gopalakrishnan,et al.  Theories of organizational structure and innovation adoption: the role of environmental change , 1998 .

[30]  Rajiv Kishore,et al.  Exploring the Moderating Effect of Trust and Privacy in the Adoption of Application Service Providers in the Healthcare Industry , 2005, Proceedings of the 38th Annual Hawaii International Conference on System Sciences.

[31]  L. Petersen,et al.  Barriers to proliferation of electronic medical records. , 2004, Informatics in primary care.

[32]  Nancy Brown,et al.  Driving EMR adoption: making EMRs a sustainable, profitable investment. , 2005, Health management technology.

[33]  Nir Menachemi,et al.  Examining the adoption of electronic health records and personal digital assistants by family physicians in Florida. , 2006, Informatics in primary care.

[34]  Robert L Edsall,et al.  Are electronic records catching on? , 2004, Family practice management.

[35]  Eric W. Ford,et al.  Predicting the adoption of electronic health records by physicians: when will health care be paperless? , 2006, Journal of the American Medical Informatics Association : JAMIA.

[36]  James Y. L. Thong,et al.  An Integrated Model of Information Systems Adoption in Small Businesses , 1999, J. Manag. Inf. Syst..

[37]  Wullianallur Raghupathi,et al.  Strategic IT applications in health care , 2002, CACM.

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