Factors associated with nurses' user resistance to change of electronic health record systems

Younghee Cho,Mona Choi,Mihui Kim

doi:10.1186/s12911-021-01581-z

Younghee Cho, Mona Choi + Show 1 more

Open Access

https://doi.org/10.1186/s12911-021-01581-z

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Abstract

BackgroundElectronic health record (EHR) systems often face user resistance in hospitals, which results in a failure to acquire their full benefits. To implement the EHR successfully, it is crucial to reduce nurses’ resistance to use the system. This study aimed to investigate the factors associated with nurses’ resistance to use the EHR system.MethodsA descriptive correlational study was conducted with nurses working at four university hospitals in Korea using self-administered questionnaires to measure user resistance behavior, resistance to change, perceived usefulness, perceived ease of use, perceived value, colleagues’ opinions, self-efficacy for change, and organizational support for change. Path analysis was performed to examine direct and indirect association with user resistance behavior.ResultsA total of 223 nurses completed the questionnaires. All seven factors were found to be significantly associated with user resistance, either directly or indirectly. The total effect on user resistance behavior was highest in resistance to change (0.65), followed by perceived usefulness (− 0.33); both had direct but no indirect effects. Conversely, self-efficacy for change (− 0.25), perceived value (− 0.21), colleagues’ opinions (− 0.16), perceived ease of use (− 0.16), and organizational support for change (− 0.05) had indirect but no direct effects.ConclusionsThe study examined the factors associated with nurses’ user resistance behavior after the implementation of a new EHR system. These findings could help hospitals develop better EHR implementation strategies to reduce user resistance behavior among the nursing staff.

Highlights

Electronic health record (EHR) systems often face user resistance in hospitals, which results in a failure to acquire their full benefits
Our study reveals that perceived ease of use does not have a direct effect on user resistance behavior which is inconsistent with Laumer et al.’s result [14]; it has an indirect effect via resistance to change Laumer et al [14] did not examine an indirect effect
Our finding shows that nurses tend to have more perceived usefulness and less resistance to change if their colleagues show favorable opinions toward new information systems, because they have similar working conditions

Summary

Introduction

Electronic health record (EHR) systems often face user resistance in hospitals, which results in a failure to acquire their full benefits. To implement the EHR successfully, it is crucial to reduce nurses’ resistance to use the system. This study aimed to investigate the factors associated with nurses’ resistance to use the EHR system. Between 2010–2015 in Korea, their adoption rate increased from 50.2 to 97.3% in tertiary teaching hospitals and from 35 to 91.4% in general hospitals [1]. Some studies have indicated that physicians’ user resistance is the primary barrier in adopting information systems in hospital settings [6, 10, 11]. Kirkley and Stein [12] indicated that resistance among nurses plays a key part in the implementation of new nursing information systems. According to Kim and Kankanhalli [13], user resistance to information systems has proven to be the biggest challenge in implementing large-scale systems

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