Paper on EHR Acceptance and Adoption
Electronic Health Record (EHR) is famous because it enhances service delivery by disseminating knowledge and awareness among healthcare professionals and patients. The system also fosters collaboration among various public and private organizations that facilitate healthcare delivery. With the increased adoption of EHR, the service delivery among several hospitals has gone far beyond traditional hospitals in terms of quality and quantity. However, despite the milestones achieved in the healthcare systems through EHR, some studies indicate that EHR acceptability among various healthcare system stakeholders varies.
A detailed analysis of this subject indicates that individual, technological and socio-environmental factors influence the adoption and utilization of EHR in healthcare systems.
- Individual Factors
- Perceived usefulness
Perceived usefulness is the degree to which people believe that using a particular system improves performance. Technological systems such as EHRs are viewed as pivotal elements to streamlining healthcare delivery processes in various ways, including medical error reduction, effective management of the disease, giving proven and guideline-based care, and enhancing efficiency (Hossain, Quaresma, & Rahman, 2019; Cowie et al. 2017 Paper on EHR Acceptance and Adoption). Concerning the reduction of errors, proper treatment of point-of-care information is the fundamental cause of medical errors. Particularly, when problems are encountered in information access, more dosing errors are likely to be experienced in various patient care stages. Error mitigation is essential not only for patient safety but also for regulatory compliance. When individuals perceive that EHRs are useful in healthcare service delivery, they are more willing to accept it and adopt it and vice versa.
- Self-efficacy and perceived ease of use.
Self-efficacy is a personal evaluation of the capacity to use new technology. The ability and familiarity of physicians towards the new technology influence their willingness. Those who find it more challenging to learn new skills of applying EHR in their work are more likely to resist its use at its conception stage and vice versa according to Hossain et al. (2019). Perceived ease of use is the degree to which people believe that using a particular system will be free of effort when applied. In the healthcare system, the perceived ease of use entails the ease of system learning and mastering, clarity and comprehensiveness of the system instructions, system flexibility, and ease of performing tasks with a minimal workload. Thus, the system complexity, workload impact, and interference with the patient and physicians’ communication reflect on the ease of use. Persons with self-efficacy in the new technologies are more likely to accept and utilize EHRs and vice versa. Thus, the perception about self-efficacy and ease of using EHR shapes the healthcare workforce attitude towards adopting the piece of technology.
- Technology-related Factors
- Uncertainties about Efficiency and Longevity
Notably, the pursuit of efficiency is one of the critical objectives of employing technology in organizations. EHRs are seen as ways of enhancing efficiency because they foster fewer resources and save administrative time during documentation and worker output improvement. Other forms of efficiency include workflow smoothness, speedy organization and retyping of information in the medical records, and quicker retrieval of patient information. Despite these advantages, maintenance costs of the systems can be high, hence discourage its adoption according to Cowie et al. (2017). Regarding uncertainty, Evans (2016) contends that new technological developments lead to obsolescence and necessitate new investments in updates and upgrades. Ideally, the perception of how the technologies such as EHR are likely to enhance healthcare system efficiency differs among individuals. Also, the costly upgrades and updates of the existing systems as a result of rapidly evolving technologies might be unwelcome to some healthcare organizations, thereby affecting the acceptance of technologies in healthcare systems.
- Additional investments
The utilization of EHRs requires healthcare professionals to have computer skills. Workforce must be trained to use new EHRs regularly and a systems officer employed to be in charge of supervising the clerks entering information in the computer systems and ensure the data is secure. That is to say, the adoption of EHRs requires additional investment in computer skills, not only among the records management departments but also the staff (Evans, 2016). The necessity to have professionals with skills in managing EHRs is a significant hindrance to the acceptance and adoption of EHRs.
- Socio-environmental Factors
- The perceived Threat to the Physician autonomy
Healthcare delivery is characterized by professional autonomy. A threat to autonomy entails the degree to which people believe that using a particular system decreases his control over the procedures, processes conditions, or content of his work. When EHR is implemented, substantial changes occur that influence positions or power relations in the medical practice (Groseclose & Buckeridge, 2017). For example, technologies enhance surveillance which is critical to healthcare service delivery. Then again, some physicians view such surveillance as an unwarranted encroachment into their professional privacy and relationship with patients according to Eberts & Capurro (2019). Thus, technologies such as EHRs are less likely to be applied where both healthcare professionals and patients believe that the technology undermines their privacy.
- Group influence
Social influence refers to the degree to which a person perceives that most essential people think he should use the system. The norms of physicians develop from professional socialization, which implies that their bonds with peers are strong and can shape perception and adoption of EHRs (Hossain et al, 2019). That is to say, the negative perceptions and decisions of colleagues towards EHR can affect its acceptability and adoption adversely.
In a nutshell, personal, technological and social factors that affect the acceptance and adoption of EHRs affect the acceptance and adoption of the systems in healthcare organizations. The individual factors include perceptions about self-efficacy, ease of use and usefulness while the technology related factors includes the costs of training personnel to use and manage them. Social factors constitutes of group influence and perceived threat to autonomy.
Paper on EHR Acceptance and Adoption References
Cowie, M. R., Blomster, J. I., Curtis, L. H., Duclaux, S., Ford, I., Fritz, F., & Michel, A. (2017). Electronic health records to facilitate clinical research. Clinical Research in Cardiology, 106(1), 1-9.DOI 10.1007/s00392-016-1025-6
Eberts, M., & Capurro, D. (2019). Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient-Physician Relationship. Applied Clinical Informatics, 10(4), 729-734. https://dx.doi.org/10.1055%2Fs-0039-1696667
Evans, R. S. (2016). Electronic health records: then, now, and in the future. Yearbook of Medical Informatics, (Suppl 1), S48. https://dx.doi.org/10.15265%2FIYS-2016-s006
Groseclose, S. L., & Buckeridge, D. L. (2017). Public health surveillance systems: recent advances in their use and evaluation. Annual Review of Public Health, 38, 57-79. https://doi.org/10.1146/annurev-publhealth-031816-044348
Hossain, A., Quaresma, R., & Rahman, H. (2019). Investigating factors influencing the physicians’ adoption of electronic health record (EHR) in the healthcare system of Bangladesh: An empirical study. International Journal of Information Management, 44, 76-87. https://doi.org/10.1016/j.ijinfomgt.2018.09.016