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Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics

  • Patient Facing Systems
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Abstract

The health care reform initiative led by the Hong Kong government’s Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients’ health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users’ and organizations’ needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users’ information technology literacy; training and technical support; and social and organizational influences. The factors are interrelated with the others. The adoption factors identified are multifaceted, ranging from technological characteristics, clinician-technology interactions, skills and knowledge, and the user-workflow-technology fit. Other findings, which have been relatively underrepresented in previous studies, contribute unique insights about the influence of work and social environment on the adoption of EMRs, including limited clinic space and the effects of physicians’ decision to use the technology on clinical staffs’ adoption decisions. Potential strategies to address the concerns, overcome adoption barriers, and define relevant policies are discussed.

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Abbreviations

EMR :

Electronic medical record

IT :

Information technology

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Acknowledgements

This study was supported in part by the Hospital Authority of Hong Kong (contract research project RCGASNA100001C; PI: Calvin Or) and the University of Hong Kong. The authors thank Irene Cheung, Katie Wong, RN, and Antonio Sek, MD, for their assistance with data collection and experimental design.

Funding

This study was supported in part by the Hospital Authority of Hong Kong (contract research project RCGASNA100001C; PI: Calvin Or) and the University of Hong Kong.

Author information

Authors and Affiliations

  1. Department of Industrial & Manufacturing Systems Engineering, The University of Hong Kong, Pokfulam, Hong Kong

    Calvin Or

  2. Health Informatics Department, Hong Kong Hospital Authority, Kowloon, Hong Kong

    Ellen Tong & Summer Chan

  3. DeGroote School of Business, McMaster University, Hamilton, ON, Canada

    Joseph Tan

Authors
  1. Calvin Or
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  2. Ellen Tong
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  3. Joseph Tan
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  4. Summer Chan
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Contributions

CO, ET, and SC contributed to the study’s conception and design and supervised the study. CO and two researchers (IC and KW, mentioned in the acknowledgements) collected and analyzed the data. CO drafted the manuscript, and all of the authors critically discussed and revised the manuscript for intellectual content. All of the authors approved the final manuscript.

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Correspondence to Calvin Or.

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Conflict of interest

None declared.

Ethics approval and consent to participate

The research team received institutional review board approval from the University of Hong Kong (reference no: EA441010) and obtained the written informed consent of the participants prior to data collection.

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Not applicable.

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This article is part of the Topical Collection on Patient Facing Systems

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Or, C., Tong, E., Tan, J. et al. Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics. J Med Syst 42, 121 (2018). https://doi.org/10.1007/s10916-018-0971-0

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  • DOI: https://doi.org/10.1007/s10916-018-0971-0

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