A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically.</p> <p>Methods</p> <p>This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed.</p> <p>Results</p> <p>The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge-based systems, to assist the adoption process of electronic health records in an automatic fashion. From our review, six critical adoption factors have been identified: user attitude towards information systems, workflow impact, interoperability, technical support, communication among users, and expert support. The main limitation of the taxonomy is the different impact of the adoption factors of electronic health records reported by some studies depending on the type of practice, setting, or attention level; however, these features are a determinant aspect with regard to the adoption rate for the latter rather than the presence of a specific critical adoption factor.</p> <p>Conclusions</p> <p>The critical adoption factors established here provide a sound theoretical basis for research to understand, support, and facilitate the adoption of electronic health records to physicians in benefit of patients.</p

The rise of the phoenix : methodological innovation as a discourse of renewal

The imperatives on contemporary organizations to adapt to an increasingly uncertain and turbulent environment are intense. The pace of change is at least as great in the public as the private sector, with technology being integral to the UK government's modernization agenda. Resilience refers to the ability of individuals and organizations to cope with change through a continuous process of renewal. Much research on resilience is uncritical, normative and written from a detached perspective that emphasizes the agency of senior management. In contrast, this paper provides an ethnographically based account of resilience at the middle level of a large, public sector bureaucracy. Finding itself under increasing pressure to move away from its traditional, technically oriented role, the IS function sought to reinvent itself as a strategic driver of business transformation. The development of a business process reengineering methodology was seen as the key to operationalizing this new role. Although innovation in IS methodology can be problematic, here it was brought off successfully. This was attributed to several factors, including the adoption of a participative action research approach and the commitment of IS management. Above all, the sense of crisis prevailing at the outset of the initiative was decisive. Crises present a major challenge to organizational sense-making; here, a resilient ‘discourse of renewal’ was kindled with the impending threat interpreted positively as a proactive opportunity to develop the new strategic identity. The paper concludes with some critical reflections on the limits of managerial agency and the notion of resilience as a designable capacity

Cultural Challenges in Information Systems Innovation: The Need for Differentiation Studies

Track IV: New Ideas in Positivist ResearchInternational audienceInformation technology (IT) innovations have been vital to the success of organizations seeking to improve efficiency and productivity. IT’s global diffusion has however raised serious questions about its neutral application across cultures and contexts. This paper synthesizes a sample of the literature to conceptualize the key cultural challenges in IS innovation as, differentiation, externality, compatibility, embeddeness. The study shows that the adoption decision is challenged by differentiation, and the adoption phase exhibits issues of externality. During implementation, compatibility is the key challenge of innovators and the assimilation literature revealed that embeddeness was the cultural challenge that phase. The synthesis also revealed that the comprehension phase where adoption decisions are made was lacking significant study. The paper proposes two opportunities for research and examples of research methods that can be use to investigate pre-adoption phenomena

The rise of the phoenix : methodological innovation as a discourse of renewal

Every 500 years (or 540, 1000, 1461, even 12,994, depending on the cultural context!), the legendary and beautifully plumaged Phoenix1 self-cremates in its nest of cinnamon twigs, rising again to embalm its predecessor in an egg of myrrh. Something of a Jungian archetype, the Phoenix symbolizes the universal cycle of birth, death and re-birth, figuring widely in religious and secular imagery, and in classical and popular culture. Renewal is the theme of this paper, but in the more mundane context of organizational resilience. Resilience is a cosmopolitan idea, encountered in many disparate domains, ranging from ecological policy (e.g. Folke et al., 2002) to child welfare (Newman and Blackburn, 2002). Although its definition is elusive (Cho et al., 2006) and its utility contested (even in seemingly well-entrenched terrain),2 the concept has gained recent prominence in the management literature, especially among the enthusiasts of ‘positive psychology’ (Luthans, 2002). Its proselytizers see resilience as an organizational capacity that can be designed and fostered as a protective shield against the apocalyptic turbulence and uncertainty of the contemporary business environment (Mallik, 1998; Hamel and Välikangas, 2003; Sheffi, 2005). Resilience is ‘the key skill for surviving in the multitude of changes as we move into the digital economy … [leaders] must cultivate the resilience of the workforce and create appropriate systems. If an organization does not create new strategies and systems that enhance organizational resilience, it will not adapt’ (Pulley, 1997)