Skip to main content
SpringerLink
Log in

Exploring Physician Adoption of EMRs: A Multi-Case Analysis

  • Original Paper
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Raghupathi, W., and Tan, J., Strategic IT applications in health care. Commun. ACM. 45(12):56–61, 2002.

    Article  Google Scholar 

  2. Brown, N., Driving EMR Adoption: Making EMRs a Sustainable, Profitable Investment. Health Manag. Technol. 26(5):47–48, 2005.

    Google Scholar 

  3. Thong, J. Y. L., An integrated model of information systems adoption in small businesses. J. Manage. Inf. Syst. 15(4):187–214, 1999.

    Google Scholar 

  4. Ford, E. W., Menachemi, N., and Phillips, M. T., Predicting the adoption of electronic health records by physicians: When will health care be paperless? J Am Med Inform Assoc. 13:106–112, 2006.

    Article  Google Scholar 

  5. Lee, S.-Y. D., and Alexander, J. A., Managing Hospitals in turbulent times: Do organizational changes improve hospital survival. Health Serv. Res. 34(4):923–946, 1999.

    Google Scholar 

  6. Madden, C. W., Excess capacity: Markets, regulation, and values. Health Serv. Res. 33(6):1651–1668, 1999.

    Google Scholar 

  7. Friedman, L. H., Goes, J. B., and Orr, R., The timing of medical technology acquisition: strategic decision making in turbulent environments. J. Healthc. Manag. 45(5):317–331, 2000.

    Google Scholar 

  8. Huston, T., Security issues for implementation of e-medical records. Commun. ACM 44(9):89–94, 2001.

    Article  Google Scholar 

  9. Iacovou, C. L., Benbasat, I., and Dexter, A. S., Electronic data interchange and small organizations: adoption & impact of technology. MIS Quarterly 19(4):465–485, 1995.

    Article  Google Scholar 

  10. Singh, R., Servoss, T., Kalsman, M., Fox, C., and Singh, G., Estimating impacts on safety caused by the introduction of electronic medical records in primary care. Informatics in Primary Care 12(4):235–242, 2004.

    Google Scholar 

  11. Meinert, D. B., Resistance to electronic medical records (EMRs): A barrier to improved quality of care. Issues in Informing Science and Information Technology 2:493–504, 2005.

    Google Scholar 

  12. Keil, M., Mann, J., and Rai, A., Why software projects escalate: An empirical analysis and test of four theoretical models. MIS Quarterly 24(4):631–664, 2000.

    Article  Google Scholar 

  13. Valdes, I., Kibbe, D. C., Tolleson, G., Kunik, M. E., and Petersen, L. A., Barriers to proliferation of electronic medical records. Informatics in Primary Care 12(1):3–9, 2004.

    Google Scholar 

  14. Foundation WKK. Using logic models to bring together planning, evaluation, & action: Logic model development guide. Battle Creek, MI; 2001.

  15. Randeree, E., Judd, S., Kishore, R., and Rao, H. R., Antecedents to the adoption of ASPs in Healthcare. Journal of Health Information Management 17(4):67–71, 2003.

    Google Scholar 

  16. Liu, L., and Ma, Q., Emerging e-business technologies for electronic medical records. Int. J. Healthc. Technol. Manag. 5(3/4/5):157–178, 2003.

    Article  Google Scholar 

  17. Bates, D. W., Ebell, M., Gotlieb, E., Zapp, J., and Mullins, H. C., A proposal for electronic medical records in U.S. primary care. J. Am. Med. Inform. Assoc. 10(1):1–10, 2003.

    Article  Google Scholar 

  18. Ang, S., and Straub, D. W., Production and Transaction economies and IS outsourcing: A study of the U.S. banking industry. MIS Quarterly 22(4):535–552, 1998.

    Article  Google Scholar 

  19. Edsall, R. L., Are electronic records catching on? Fam. Pract. Manag. 11(3):13, 2004.

    Google Scholar 

  20. Paul, D. L., Reuben, R., and McDaniel, J., A field study of the effect of interpersonal trust on virtual collaborative relationship performance. MIS Quarterly 28(2):183–227, 2004.

    Google Scholar 

  21. Ring, P. S., and Van de Ven, A., Developmental processes of cooperative interorganizational relationships. Acad. Manage. Rev. 19(1):90–119, 1994.

    Article  Google Scholar 

  22. Gefen, D., Karahanna, E., and Straub, D. W., Trust and TAM in online shopping: An integrated model. MIS Quarterly 27(1):51–90, 2003.

    Google Scholar 

  23. Jeffries, F. L., and Reed, R., Trust and adaptation in relational contracting. Acad. Manage. Rev. 25(4):873–882, 2000.

    Article  Google Scholar 

  24. Hart, P. J., and Saunders, C. S., Emerging electronic partnerships: antecedents and dimensions of EDI use from the supplier’s perspective. J. Manage. Inf. Syst. 14(4):87–111, 1998.

    Google Scholar 

  25. Sabherwal, R., The role of trust in outsourced is development project. Commun. ACM 42(2):80–86, 1999.

    Article  Google Scholar 

  26. Barthelemy, J., The hard and soft sides of IT outsourcing management. Eur. Manag. J. 21(5):539–548, 2003.

    Article  Google Scholar 

  27. Heart, T., and Pliskin, N., Is E-commerce of IT Application services (ASP) alive and well? JITTA 3(4):33–41, 2001.

    Google Scholar 

  28. Zaheer, A., McEvily, B., and Perrone, V., Does trust matter? Exploring the effects of interorganizational and interpersonal trust on performance. Organ. Sci. 9(2):141–159, 1998.

    Article  Google Scholar 

  29. Uzzi, B., Social structure and competition in interfirm networks: The paradox of embeddedness. Adm. Sci. Q. 42(1):35–67, 1997.

    Article  Google Scholar 

  30. Randeree, E., Kishore, R., and Rao, H. R., Exploring the moderating effect of trust and privacy in the adoption of application service providers in the healthcare industry. Hawaii International Conference on System Sciences; 2005; Hawaii; 2005, 1–10.

  31. Kurtz, G., EMR confidentiality and information security. J. Healthc. Inf. Manag. 17(3):41–48, 2003.

    MathSciNet  Google Scholar 

  32. Gopalakrishnan, S., and Damanpour, F., Patterns of generation and adoption of innovation in organizations: Contingency models of innovation attributes. J. Eng. Technol. Manag. 11(2):95–117, 1994.

    Article  Google Scholar 

  33. Damanpour, F., and Gopalakrishnan, S., Theories of organizational structure and innovation adoption: The role of environmental change. J. Eng. Technol. Manag. 15(1):1–24, 1998.

    Article  Google Scholar 

  34. Rogers, E. M., The diffusion of innovations, 5th ed. Free Press, New York, 2003.

    Google Scholar 

  35. Nidumolu, S. R., and Knotts, G. W., The Effects of customizability and reusability on perceived process and competitive performance of software firms. MIS Quarterly 22(2):105–137, 1998.

    Article  Google Scholar 

  36. Karsh, B.-T., Beasley, J., and Hagenauer, M. E., Are electronic medical records associated with improved perceptions of the quality of medical records, working conditions, or quality of working life? Behav. Inf. Technol. 23(5):327–335, 2004.

    Article  Google Scholar 

  37. Menachemi, N., Perkins, R. M., van Durme, D. J., and Brooks, R. G., Examining the adoption of electronic health records and personal digital assistants by family physicians in Florida. Informatics in Primary Care 14:1–9, 2006.

    Google Scholar 

  38. Menachemi, N., and Brooks, R. G., Reviewing the benefits and costs of electronic health records and associated patient safety technologies. J. Med. Syst. 30(3):159–168, 2006.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. College of Information, Florida State University, 234 Louis Shores Building, Tallahassee, FL, 32306-2100, USA

    Ebrahim Randeree

Authors
  1. Ebrahim Randeree
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ebrahim Randeree.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Randeree, E. Exploring Physician Adoption of EMRs: A Multi-Case Analysis. J Med Syst 31, 489–496 (2007). https://doi.org/10.1007/s10916-007-9089-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10916-007-9089-5

Keywords

Search

Navigation