Please use this identifier to cite or link to this item: http://scholarbank.nus.edu.sg/handle/10635/33305
Title: EMPOWERING PHYSICIANS WITH ELECTRONIC HEALTH RECORD SYSTEMS: FROM SYSTEM CAPABILITIES TO ADOPTION INTENTION
Authors: XU LINGLING
Keywords: Adoption intention; Psychological empowerment; Empowering structures; Electronic Health Record systems; Information system capabilities; Physicians
Issue Date: 18-Oct-2011
Source: XU LINGLING (2011-10-18). EMPOWERING PHYSICIANS WITH ELECTRONIC HEALTH RECORD SYSTEMS: FROM SYSTEM CAPABILITIES TO ADOPTION INTENTION. ScholarBank@NUS Repository.
Abstract: In recent years, many countries have taken a keen interest in developing a more integrated healthcare system and specifically Electronic Health Record (EHR). EHR is the critical foundational technology through which the interoperability and exchange of health information can take place. With various capabilities for clinical management and administrative support, EHR systems are expected to empower healthcare providers towards improved patient care, reduced medical errors and lowered care costs. Despite these potential benefits, the adoption of EHR systems among physicians has been very slow in most countries. Notably, adoption rates tend to be dependent on capabilities of the systems, with lower rates for EHR systems having more capabilities/functions. Without wide adoption of more comprehensive EHR systems by physicians, the full potential of EHR for integrated healthcare might not be realized. Therefore, it is imperative to investigate factors influencing physicians¿ adoption of EHR systems. With a particular interest in the influence from capabilities/functions of the systems, this thesis aims at exploring whether and how perceptions about different EHR capabilities/functions exert different influences on physicians¿ adoption intention. Drawing upon empowerment theory and structurational models of technology, this thesis establishes a theoretical linkage between capabilities of an EHR system and physicians¿ intention to adopt the EHR system, through the mediation of psychological empowerment. Specifically, it posits that perceived existence of four EHR capabilities, namely, workflow automation, communication, decision support, and administrative support, changes physicians¿ anticipated psychological empowerment (meaning, competence, self-determination and impact dimensions) associated with the use of an EHR system through different mechanisms, and that anticipated psychological empowerment dimensions subsequently influence physicians¿ intention to adopt the EHR system. The proposed theoretical model was tested using field survey data from 248 primary care physicians from Singapore. The results show that two psychological empowerment dimensions, meaning and self-determination, significantly predicted physicians¿ intention to adoption an EHR system. The four EHR capabilities shaped psychological empowerment differently. Specifically, the existence of workflow automation capability in an EHR system positively affected physicians¿ anticipated meaning and competence; the existence of connectivity capability positively affected physicians¿ anticipated meaning, competence and self-determination; the existence of decision support capability negatively affected physicians¿ anticipated self-determination; and the existence of administrative support capability positively affected physicians¿ anticipated competence, self-determination and impact. This research offers a fresh perspective on mechanisms through which information system (IS) capabilities influence IS adoption intention at the individual level. Implications for EHR developers, promoters and policy makers are discussed.
URI: http://scholarbank.nus.edu.sg/handle/10635/33305
Appears in Collections:Ph.D Theses (Open)

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