BackgroundThis paper adopts a communication and sociocultural perspective to analyze the factors behind the lag in electronic medical record (EMR) adoption in the United States. Much of the extant research on this topic has emphasized economic factors, particularly, lack of economic incentives, as the primary cause of the delay in EMR adoption. This prompted the Health Information Technology on Economic and Clinical Health Act that allow financial incentives through the Centers of Medicare and Medicaid Services for many health care organizations planning to adopt EMR. However, financial incentives alone have not solved the problem; many new innovations do not diffuse even when offered for free. Thus, this paper underlines the need to consider communication and sociocultural factors to develop a better understanding of the impediments of EMR adoption.ObjectiveThe objective of this paper was to develop a holistic understanding of EMR adoption by identifying and analyzing the impact of communication and sociocultural factors that operate at 3 levels: macro (environmental), meso (organizational), and micro (individual).MethodsWe use the systems approach to focus on the 3 levels (macro, meso, and micro) and developed propositions at each level drawing on the communication and sociocultural perspectives.ResultsOur analysis resulted in 10 propositions that connect communication and sociocultural aspects with EMR adoption.ConclusionsThis paper brings perspectives from the social sciences that have largely been missing in the extant literature of health information technology (HIT) adoption. In doing so, it implies how communication and sociocultural factors may complement (and in some instances, reinforce) the impact of economic factors on HIT adoption.
Since social marketing’s formal introduction in 1971, the field has advanced through employing innovations in marketing thought. Despite debates over whether or not marketing principles should be used to promote socially beneficial behaviors, the field has become successful at utilizing such practices to achieve its goals. However, even with these advancements, social marketing research has yet to fully consider how the use of traditional marketing practices in socially oriented settings can alter the way stakeholders perceive and interact with the organizations employing these tactics. This article examines how parallels between nonprofit management and social marketing research illustrate how socially oriented organizations can damage their legitimacy as change agents and community partners by not evaluating the true costs of employing marketing techniques. Both warnings and recommendations are provided to help the managers of social marketing efforts more effectively evaluate both the costs and benefits of their decisions.
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