Systeme d’information hospitalier et autonomie professionnelle

National audienc

Systeme d’information hospitalier et autonomie professionnelle

National audienc

Professional Facing Coercive Work Formalization: Vicious Circle of the Electronic Medical Record (EMR) Implementation and Appropriation

AbstractThis paper shows that, according to many studies, the implementation of the Electronic Medical Record (EMR) does not cause efficient uses as expected in hospitals. Authors suggest explanatory factors, including both generic factors related to the implementation of ERP and specific factors related to health sector, in particular to professional bureaucracies (professional autonomy, divergence of goals, lack of coordination). The paper highlights the risk of a vicious circle of clinical process computerization, similar to bureaucratic vicious circle described by Crozier (Crozier 1965). Specifically, the convergence of two information systems, the clinical one and the administrative one inside the EMR, is a source of conflict between two logics, one focused on the professional to manage the care of a given patient, and the other focused on the resources management for all patients. The dominance of the administrative logic, consisting in monitoring and promoting coercive formalization, is likely to reduce the professional adjustment and autonomy, to cause their resistance and, consequently, the absence of effective uses, which lead back a strengthening of the control logic. The author shows interest to consider this conflict to reverse the situation by enabling approach, using professional autonomy as lever

Reflecting on a Hospital Information System adoption: islets of enabling adoption inside a coercive system

International audienc

Reflecting on a Hospital Information System adoption: islets of enabling adoption inside a coercive system

International audienc

Reflecting on a Hospital Information System adoption: islets of enabling adoption inside a coercive system

International audienc

Perceptions of an Electronic Medical Record (EMR): Lessons from a French Longitudinal Survey

AbstractThe goal of this longitudinal study is to examine the evolution of the perceptions, namely anxiety, ease of use, usefulness, misfit (not customization), trust and usefulness, related to an Electronic Medical Record (EMR) for the clinical staff in a French Teaching hospital. Two surveys were conducted first in September 2013 and second in December 2015, based on a questionnaire consisting of items on the Likert scale. As results, the correlation of all the variables between the two surveys is very significant (except for usefulness, for which the relationship is significant). This is not surprising, given previous studied focused on habits and learning related to technology adoption. Nevertheless, the increase is not spectacular and it makes necessary to evaluate EMR satisfaction and perceptions in order to elaborate a measure standard enabling comparisons and benchmarking among hospitals

Understanding the acceptance factors of a Hospital Information System: evidence from a French University Hospital

International audienc