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J Biomed Inform. 2014 Apr;48:17-27. doi: 10.1016/j.jbi.2013.10.010. Epub 2013 Oct 31.

Electronic health record acceptance by physicians: testing an integrated theoretical model.

Author information

1
Research Center of the CHU de Québec. 10 rue de l'Espinay, Quebec City, Quebec G1L 3L5, Canada; Faculty of Nursing Sciences, Université Laval, 1050 avenue de la Médecine, Quebec City, Quebec G1V 0A6, Canada. Electronic address: marie-pierre.gagnon@fsi.ulaval.ca.
2
Research Center of the CHU de Québec. 10 rue de l'Espinay, Quebec City, Quebec G1L 3L5, Canada.
3
Faculty of Nursing Sciences, Université Laval, 1050 avenue de la Médecine, Quebec City, Quebec G1V 0A6, Canada.
4
Research Center of the CHU de Québec. 10 rue de l'Espinay, Quebec City, Quebec G1L 3L5, Canada; Department of Political Science, Université Laval, 1030, avenue des Sciences-Humaines, Quebec City, Quebec G1V 0A6, Canada.
5
Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, C.P. 500, Trois-Rivières, Quebec G9A 5H7, Canada.

Abstract

OBJECTIVE:

Several countries are in the process of implementing an Electronic Health Record (EHR), but limited physicians' acceptance of this technology presents a serious threat to its successful implementation. The aim of this study was to identify the main determinants of physician acceptance of EHR in a sample of general practitioners and specialists of the Province of Quebec (Canada).

METHODS:

We sent an electronic questionnaire to physician members of the Quebec Medical Association. We tested four theoretical models (Technology acceptance model (TAM), Extended TAM, Psychosocial Model, and Integrated Model) using path analysis and multiple linear regression analysis in order to identify the main determinants of physicians' intention to use the EHR. We evaluated the modifying effect of sociodemographic characteristics using multi-group analysis of structural weights invariance.

RESULTS:

A total of 157 questionnaires were returned. The four models performed well and explained between 44% and 55% of the variance in physicians' intention to use the EHR. The Integrated model performed the best and showed that perceived ease of use, professional norm, social norm, and demonstrability of the results are the strongest predictors of physicians' intention to use the EHR. Age, gender, previous experience and specialty modified the association between those determinants and intention.

CONCLUSIONS:

The proposed integrated theoretical model is useful in identifying which factors could motivate physicians from different backgrounds to use the EHR. Physicians who perceive the EHR to be easy to use, coherent with their professional norms, supported by their peers and patients, and able to demonstrate tangible results are more likely to accept this technology. Age, gender, specialty and experience should also be taken into account when developing EHR implementation strategies targeting physicians.

KEYWORDS:

Acceptance; Electronic health record; Physicians; TAM; Theoretical model

PMID:
24184678
DOI:
10.1016/j.jbi.2013.10.010
[Indexed for MEDLINE]
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