Abstract
The implementation of hospital-wide Electronic Medical Records (EMRs) is still an unsolved quest for many hospital managers. EMRs have long been considered a key factor for improving healthcare quality and safety, reducing adverse events for patients, decreasing costs, optimizing processes, improving clinical research and obtaining best clinical performances. However, hospitals continue to experience resistance from professionals to accepting EMRs. This study combines institutional and individual factors to explain which determinants can trigger or inhibit the EMRs implementation in hospitals, and which variables managers can exploit to guide professionals’ behaviours. Data have been collected through a survey administered to physicians and nurses in an Italian University Hospital in Rome. A total of 114 high-quality responses had been received. Results show that both, physicians and nurses, expect many benefits from the use of EMRs. In particular, it is believed that the EMRs will have a positive impact on quality, efficiency and effectiveness of care; handover communication between healthcare workers; teaching, tutoring and research activities; greater control of your own business. Moreover, data show an interplay between individual and institutional determinants: normative factors directly affect perceived usefulness (C = 0.30 **), perceived ease of use (C = 0.26 **) and intention to use EMRs (C = 0.33 **), regulative factors affect the intention to use EMRs (C = -0.21 **), and perceived usefulness directly affect the intention to use EMRs (C = 0.33 **). The analysis carried out shows that the key determinants of the intention to use EMRs are the normative ones (peer influence) and the individual ones (perceived usefulness), and that perceived usefulness works also as a mediator between normative factors and intention to use EMRs. Therefore, Management can leverage on power users to motivate, generate and manage change.
Highlights
Healthcare is the most complex and fast-moving industry that exists
Findings confirmed the positive role played by the perceived usefulness as driving individual factor to the intention to use Electronic Medical Records (EMRs) and shed light on the significant positive role played by the normative factors [2], both with direct and indirect effects
Hospital managers can leverage on lead peer influence to motivate, generate and manage change and generate a virtuous circle inside the hospital to motivate the use of EMRs
Summary
Healthcare is the most complex and fast-moving industry that exists. New digital technologies are constantly being developed, all with the potential to support the clinical practice by bringing many advantages into the healthcare sector [1]. The healthcare industry has lagged behind other sectors in the adoption of Information Technology (IT) in the workplace [2]. Though many research and development programs exist and venture capital investment has been growing, successful IT projects in healthcare continue to be rare, and a plan to accelerate innovation is needed beginning with a diagnosis of the problem [2]. Some studies analyzed both individual and organizational factors that affect the acceptance and implementation of technology [8], but they have generated mixed results [9]. Information Science has mostly adopted user acceptance models, which emphasise individuals’ rational and volitional assessment of the costs and benefits they would attain from the new digital technology [11]
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