Electronic Medical Records implementation in hospital: An empirical investigation of individual and organizational determinants

• Published in: PloS one Vol. 15; no. 6; p. e0234108
• Main Authors: De Benedictis, Anna, Lettieri, Emanuele, Gastaldi, Luca, Masella, Cristina, Urgu, Alessia, Tartaglini, Daniela
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 04-06-2020; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Change management; Clinical trials; College campuses; Computer and Information Sciences; Digital technology; Electronic health records; Electronic medical records; Electronic records; Empirical analysis; Health care; Health care reform; Hospital administration; Hospital information systems; Hospitals; Industrial engineering; Information science; Information technology; Institutionalization; Medical care quality; Medical personnel; Medical personnel training; Medical profession; Medical records; Medical research; Medicine and Health Sciences; Motivation; Nurses; Organizational aspects; Peer pressure; People and Places; Physicians; Power (Philosophy); Professionals; R&D; Research & development; Research and Analysis Methods; Retirement benefits; Social Sciences; Studies; Surveys; Teachers; Technology; Technology Acceptance Model; Technology adoption; Theory; Tutoring; Workers; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0234108

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.