Hwang Hsin-Ginn, Dutta Bireswar, Chang Hui-Chuan
Institute of Information Management, National Chiao Tung University, Hsinchu, Taiwan.
Yuan General Hospital, Kaohsiung, Taiwan.
Methods Inf Med. 2019 Dec;58(S 02):e58-e71. doi: 10.1055/s-0039-1695718. Epub 2019 Sep 9.
The use of electronic medical record (EMR) is anticipated to bring benefits for patients, physicians, and organizations. But limited physicians' acceptance of EMR presents a serious threat to its effective implementation.
The current study incorporates technology acceptance model (TAM) with two antecedents, gender, and clinical specialty and one context-specific factor, financial incentives, to identify the factors that influence physicians' intention to use EMR in Taiwan.
The survey methodology was used to collect data from the physicians, working in the regional hospital that had implemented EMR system. A total of 119 out of 213 questionnaires returned in a response rate of 56%. But four responses were considered ineffective due to missing values. The structural equation modeling (SEM) technique was employed to analyze the research framework.
The partial least squares (PLS) regression indicated that three factors perceived usefulness, financial incentives, and attitude toward using EMR significantly affect physicians' intention. But concerning perceived ease of use (PEOU), an insignificant path coefficient was reported. Additionally, regression analysis showed gender, and clinical specialty positively influenced physicians' intention to use EMR.
The proposed research framework contributes to the conclusive explanation for interpreting physicians' intention to use EMR. Physicians generally have a higher level of computer literacy. Therefore, the factor of PEOU could not be critical regarding adopting new health information technology (HIT). This study also brings perspectives from the gender, and clinical differences have primarily been missing in the literature of the physicians' intention to use HIT. In doing so, it infers how gender, and clinical specialty, may complement (and in some instances, reinforce) the influence of technological and attitudinal factors of HIT use. Thus, health care providers must take these factors into consideration in the development and validation of the theories regarding the intention to use EMR.
电子病历（EMR）的使用有望给患者、医生和医疗机构带来益处。但医生对电子病历的接受程度有限，这对其有效实施构成了严重威胁。
本研究将技术接受模型（TAM）与两个前置因素（性别和临床专业）以及一个特定情境因素（经济激励）相结合，以确定影响台湾地区医生使用电子病历意愿的因素。
采用调查方法收集在已实施电子病历系统的区域医院工作的医生的数据。共回收213份问卷中的119份，回复率为56%。但由于存在缺失值，4份回复被视为无效。采用结构方程模型（SEM）技术分析研究框架。
偏最小二乘法（PLS）回归表明，三个因素——感知有用性、经济激励和对使用电子病历的态度——显著影响医生的意愿。但关于感知易用性（PEOU），报告的路径系数不显著。此外，回归分析表明，性别和临床专业对医生使用电子病历的意愿有积极影响。
所提出的研究框架有助于对医生使用电子病历的意愿作出结论性解释。医生通常具有较高的计算机素养。因此，对于采用新的健康信息技术（HIT）而言，感知易用性因素可能并不关键。本研究还从性别和临床差异的角度进行了探讨，而这些在医生使用HIT意愿的文献中主要是缺失的。通过这样做，推断出性别和临床专业如何补充（在某些情况下，加强）HIT使用的技术和态度因素的影响。因此，医疗保健提供者在关于使用电子病历意愿的理论的发展和验证中必须考虑这些因素。
