El-Yafouri Raghid, Klieb Leslie, Sabatier Valérie
Grenoble Ecole de Management, Grenoble, France.
Tenxor Inc, San Francisco, CA, USA.
Health Res Policy Syst. 2022 May 2;20(1):48. doi: 10.1186/s12961-022-00851-0.
Wide adoption of electronic medical records (EMR) systems in the United States can lead to better-quality medical care at lower cost. Despite the laws and financial subsidies by the United States government for service providers and suppliers, interoperability still lags. An understanding of the drivers of EMR adoption for physicians and the role of policy-making can translate into increased adoption and enhanced information sharing between medical care providers.
Physicians across the United States were surveyed to gather primary data on their psychological, social and technical perceptions towards EMR systems. This quantitative study builds on the theory of planned behaviour, the technology acceptance model and the diffusion of innovation theory to propose, test and validate an innovation adoption model for the healthcare industry. A total of 382 responses were collected, and data were analysed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.
Regression model testing uncovered that government policy-making or mandates and other social factors have little or negligible effect on physicians' intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry and the relative advancement of the system compared to others.
Identifying physicians' needs regarding EMR systems and providing programmes that meet them can increase the potential for reaching the goal of nationwide interoperable medical records. Government, healthcare associations and EMR system vendors can benefit from our findings by working towards increasing physicians' knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.
电子病历（EMR）系统在美国的广泛应用能够以更低成本带来更高质量的医疗服务。尽管美国政府为服务提供商和供应商提供了法律支持及财政补贴，但互操作性仍然滞后。了解医生采用电子病历的驱动因素以及政策制定的作用，有助于提高采用率并加强医疗服务提供者之间的信息共享。
对美国各地的医生进行了调查，以收集他们对电子病历系统的心理、社会和技术认知的原始数据。这项定量研究基于计划行为理论、技术接受模型和创新扩散理论，提出、测试并验证了一个针对医疗行业的创新采用模型。共收集到382份回复，并通过线性回归分析数据，以揭示12个变量对采用电子病历系统意向的影响。
回归模型测试发现，政府政策制定或指令以及其他社会因素对医生采用创新的意向影响很小或可忽略不计。相反，医生直接受到他们的态度和控制能力的驱动，间接受到他们对创新的了解、获取系统的财务能力、该系统对其行业的整体益处以及与其他系统相比该系统的相对先进性的激励。
确定医生对电子病历系统的需求并提供满足这些需求的方案，可以增加实现全国范围内可互操作医疗记录这一目标的可能性。政府、医疗协会和电子病历系统供应商可以从我们的研究结果中受益，方法是努力增加医生对拟议创新的了解，宣传医疗服务提供者和整个行业如何能从采用电子病历系统中受益，并解决系统实施和维护的财政负担。
