The used theories for the adoption of electronic health record: a systematic literature review

Sadoughi, Farahnaz; Khodaveisi, Taleb; Ahmadi, Hossein

doi:10.1007/s12553-018-0277-8

Cited by 27 publications

(17 citation statements)

References 88 publications

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“…Besides country-wide studies, there is an increasing number of studies about EHR adoption in the health system. The most recent review published in 2019 criticized 18 studies between 2005 and 2017, which are applied in different healthcare facilities from primary to tertiary healthcare services [76].…”

Section: Discussionmentioning

confidence: 99%

Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

Kose

Rayner²,

Birinci

et al. 2020

BMC Health Serv Res

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Background Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

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Section: Discussionmentioning

confidence: 99%

Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

Kose

Rayner²,

Birinci

et al. 2020

BMC Health Serv Res

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“…However, the application of institutional theory in this context is still relatively rare compared to TAM and UTAUT. Institutional theory did not appear in a recent literature review of the most common theories to explain EHR adoption or engagement [9].…”

Section: Is Theories and Ehr Engagementmentioning

confidence: 99%

“…This means it is unclear if users would prefer to work with the EHR as little as possible or if they would prefer to integrate features of the EHR with their primary role. Despite these different possibilities, most EHR acceptance studies typically use the measures provided by TAM and UTAUT [9].…”

Section: Is Theories and Ehr Engagementmentioning

confidence: 99%

“…With notable exceptions, researchers have primarily drawn from prior theory on technology acceptance or continuance to explain EHR end-user behaviors; most prominently the technology acceptance model (TAM) [7] and the unified theories of acceptance and use of technology (UTAUT) [8] (for a review, see [9]). However, these theories were originally developed for general organizational information systems (e.g., enterprise resource planning systems, accounting systems, human resources systems, and marketing and sales systems, etc.)…”

Section: Introductionmentioning

confidence: 99%

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An Institutional Theory Perspective on EHR Engagement: Mandates, Penalties, and Enforcement

Keith¹,

Stewart²,

Stewart³

et al. 2022

Proceedings of the Annual Hawaii International Conference on System Sciences

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Electronic Health Record (EHR) systems are the predominant information system (IS) used by healthcare clinicians and have been the source of both great success and pain. User engagement with EHR systems is unique from traditional IS contexts in significant ways. Prior research explains EHR usage and success primarily on traditional technology acceptance research (i.e., TAM, UTAUT). However, these models assume that EHR engagement is no different from IS systems in general business domains. Yet, the healthcare context is far more regulated than most. Based on qualitative focus group sessions with a leading healthcare analytics firm (KLAS Research), we identify the role of mandates, penalties, and enforcements from government, organizations, associations, and insurance companies in explaining EHR engagement. We validate a measurement instrument for these factors and demonstrate that their inclusion can improve model fit five times over a traditional UTAUT-based model (R 2 = 54.8% versus 10.2%).

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“…In participatory design, user acceptance plays a central role [31,32]. The theoretical basis is provided by acceptance models such as the "Unified Theory of Acceptance and Use of Technology (UTAUT; [33,34])". The UTAUT is considered as one of the main frameworks for the evaluation of EMR [35].…”

Section: Introductionmentioning

confidence: 99%

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

et al. 2021

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Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements.

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The used theories for the adoption of electronic health record: a systematic literature review

Cited by 27 publications

References 88 publications

Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

An Institutional Theory Perspective on EHR Engagement: Mandates, Penalties, and Enforcement

Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians

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