A Three Country Study for Understanding Physicians' Engagement With Electronic Information Resources Pre and Post System Implementation

Deriving the benefits of electronic information resources as provided by electronic medical record systems (EMR) on a global scale is critically dependent on physicians' adoption and continued use of such resources. Yet, there is little known about the factors that motivate physicians to adopt and continue to use electronic information resources. The purpose of this article is to investigate the motivational factors leading to adoption and usage of electronic information resources in diverse regions of the world including developing countries (India and Egypt) and developed countries (the US). Based on the socio-cognitive theory and the decomposed theory of planned behavior, the authors surveyed 314 physicians in three countries in order to assess their engagement with electronic information resources. Data was analyzed via PLS for direct and indirect effects of socio-cognitive constructs and their impact on electronic information resources' use intentions. The authors' results suggest there are similarities as well as differences in factors impacting adoption and usage of electronic information resources pre and post EMR implementation in both developing and developed countries. They found that physicians' perceptions of effort expectations, technological infrastructure and support, and computer self-efficacy were the strongest direct drivers influencing intentions to use electronic information resources both in pre and post-EMR implementations in all three countries that were studied. However, a richer set of factors contributed to physicians' intentions to continue to use electronic information resources, post-EMR, in developed countries as compared to pre-EMR in developing countries. Social influences had a strong indirect effects, influencing physicians' perceptions of effort expectations post-EMR as well as perceptions of performance expectations pre-EMR implementation. Computer self-efficacy was a significant predictor of effort expectations of an electronic information resource both pre and post-EMR implementation while compatibility with physicians' practices significantly influenced performance expectations in both pre and post EMR implementations in all three countries studied. The authors' study provides important theoretical and practical implications for successful management and implementation of electronic information resources such that they are adopted and used in the healthcare environment.