AN EMPIRICAL STUDY ON THE PHYSICIANS’ BEHAVIORAL INTENTION WITH ELECTRONIC MEDICAL RECORD SYSTEMS IN TAIWAN

Currently in healthcare organizations paper-based patient record management faces many challenges. Most countries are promoting the full implementation of electronic medical records in every hospital. Medical environments change frequently and dramatically, which makes full acceptance of electronic medical records (EMR) by physicians an important issue. This empirical study combines the theory on reasoned action (TRA) and information technology acceptance model (TAM) resulted in a modified TAM to find what critical factors influence the acceptance behavior of EMR by physicians. To test these hypotheses, this study administered a cross-sectional mailed questionnaire survey during the period of three months in 2012. The survey was deployed to1000 physicians randomly from the estimated total 2000 physicians of 50 regional acute hospitals (more than 300 beds) in Taiwan currently. From these, 252effective responses were received, resulting in a net response rate of 25%. These research findings indicate that four variables significantly positively impact the intention to adopt EMR. Among these, attitude has the most significant positive impact on adoption intentions. Moreover, it shows that the professional autonomy might play an important role to moderate the attitude with significant statistics. These results maintain enough explanatory power (R2 =78.4%) to help explain the attitudes and intentions of physicians in adopting electronic medical record information systems. Our analysis revealed the importance of the perception usefulness which moderated by professional autonomy and pragmatism by physicians for their adoption electronic medical record systems in clinical practice

A Multi-Case Investigation of Electronic Health Record Implementation in Small- and Medium-Size Physician Practices

The American healthcare system has undergone significant changes as health information technology (HIT) has evolved. According to the Institute of Medicine (IOM, 2001), “Automation of clinical, financial, and administrative transactions is essential to improving quality, preventing errors, enhancing consumer confidence in the health system, and improving efficiency” (p. 16). HIT helps target improvements in patient care through improved adherence to clinical guidelines, improved monitoring of diseases, reduction in medical and medication errors, and access to more accurate and complete health information that aids in the decision-making process (Cecchini, 2011a). However, these improvements are not guaranteed just because an electronic health record (EHR) is implemented. Improvement in the quality of care is dependent on what the specific EHR offers in the way of functionality and how it affects providers and office staff (Carayon, Smith, Hundt, Kuruchittham, & Li 2009)

Health information technology (HIT) in small and medium sized physician practices: examination of impacts and HIT maturity

Small and medium sized physician practices (SMPP) are medical practices that consist of a staff of less than 10 physicians. Nearly 60% of the US physicians work in SMPP and face more barriers to HIT adoption and implementation than their larger counterparts. The dissertation is on the use and impact of Health Information Technology (HIT) on SMPP. The dissertation will also explore the effects of IT maturity on health care organizations’ abilities to impact outcomes. It will examine how SMPP have grown through the use of IT and how this has impacted the organization’s use of HIT. While previous work has observed some organizational impacts of HIT, they have only studied a single phenomenon that had been impacted and not how the organization as a whole is impacted. While researchers have found that organizations with higher IT maturity tend to show better operational and financial performance, very little prior studies have shown the impact of HIT maturity on SMPP. The dissertation’s goal is to answer the following questions: 1. How does HIT usage influence the organizational impacts on Small and Medium Sized Physician Practices? 2. How does the SMPP’s HIT maturity influence these impacts? To answer these questions, the dissertation used a framework derived from DeLone and McLean’s (1992, 2003) IS Success Model and the IT Value Hierarchy (Urwiler & Frolick, 2008). The dissertation employed a multiple case study approach by collecting and analyzing data from various members of five different SMPP. The dissertation found that the process of HIT documentation had a major influence on the SMPP. While it has a positive impact on the patient’s Quality of Care, it has a negative impact on Productivity and User Satisfaction. While prior HIT research found that communication was a final outcome of HIT use, this dissertation found that communication is a mitigating factor influencing organizational impacts