Acceptance and Usage of Electronic Health Record Systems in Small Medical Practices.

One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in officebased practices. The purpose of this study was to explore opinions and beliefs on the barriers to the diffusion of an ERH system using Q-methodology. Specifically, the research questions examined the subjectivity in the patterns of perspectives at the preadoption stage of the nonusers and at the postadoption stage of the users of an EHR system to facilitate effective diffusion. Data were collected by self-referred rank ordering of opinions on such barriers and facilitators. The results suggested that the postadoption barriers of time, change in work processes, and organizational factors were critical. Although the time barrier was common, barriers of organizational culture and change in work processes differed among typologies of perspectives at the postadoption stage. Preadoption barriers of finance, organizational culture, time, technology, and autonomy were critical. The typologies of perspectives diverged on critical barriers at the preadoptive stage. A customized solution of an in-house system and training is recommended for perspectives dealing with technical and organizational concerns and a web-based system for perspectives concerned with barriers of finance, technology, and organization. The social impact of tailoring solutions to personal viewpoints would result in the increased sharing of quality medical information for meaningful decision making. Acceptance and Usage of Electronic Health Record Systems in Small Medical Practices by Ritu Tannan MBA, University of Wisconsin, Oshkosh, 1993 BS, University of Delhi, Gargi College, 1982 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy School of Management Walden University November 2012 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 1346 UMI 3544944 Published by ProQuest LLC (2012). Copyright in the Dissertation held by the Author. UMI Number: 3544944 Dedication This dissertation is dedicated to my mother who inspired me with her dedication and courage to overcome all adversity with determination and perseverance. She instilled the belief that education is an indestructible and invaluable wealth, just like a carving on a stone. Her mentorship led me to pursue my doctoral studies without any reservations for time or reward. Acknowledgments First and foremost, I thank the almighty power that opened the door and led me through this humbling experience. With sincere and deep gratitude, I wish to acknowledge all those who provided guidance and support to me on this journey, including Dr. Anthony Lolas, my adviser and committee chair, and the members of my committee, Dr. Walter McCollum and Dr. Louis Taylor. I especially thank and appreciate the words of understanding, help, and assistance from my colleagues and close friends. My deepest gratitude goes to my husband, Dilip, and my two daughters, Anjali and Neha, whose love, encouragement, and help throughout this journey have been firm and constant. They spent hours reading and critiquing the document for improvements. Their supportive words changed my frustrations into a new hope.