An organizational learning perspective on the assimilation of electronic medical records among small physician practices
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An organizational learning perspective on the assimilation of electronic medical records among small physician practices John L. Reardon1 and Elizabeth Davidson1 1
Department of Information Technology Management, Shidler College of Business, University of Hawai’i at Manoa, Honolulu, Hawaii, U.S.A. Correspondence: John L. Reardon, Department of Information Technology Management, Shidler College of Business, University of Hawai’i at Manoa, Honolulu, Hawaii 96822, U.S.A. Tel: þ 1 808 956 7309; Fax: þ 1 808 956 9889; E-mail: [email protected]
Abstract Small physician practices play an essential role in the healthcare delivery system but are least likely to adopt health information technologies such as electronic medical records (EMRs). Factors contributing to low adoption include investment cost, productivity loss, and lack of financial incentives. However, these factors do not explain why some small practices, which face similar challenges nonetheless assimilate EMRs, while others do not. We investigated the assimilation of EMRs from the theoretic perspective of organizational learning in a survey of small physician practices and evaluated whether characteristics associated with organizational learning barriers are related to EMR assimilation. We found that learning-related scale, related knowledge, and diversity were positively associated with small physician practices’ stage of assimilation of EMR technology. Our findings suggest that some small practices are able to overcome the substantial learning barriers presented by EMRs but that others will require support to develop sufficient learning capacity. We consider implications for practice from this research and areas requiring further research. European Journal of Information Systems (2007) 16, 681–694. doi:10.1057/palgrave.ejis.3000714 Keywords: organizational learning; adoption; assimilation; electronic medical records
Introduction High costs, medical errors, variable quality, administrative inefficiencies, and poor coordination are often cited as major problems within the U.S. healthcare system (Kohn et al., 1999; Porter & Teisberg, 2004; WHEP, 2004). Various healthcare constituencies have detailed how IT might be used to address these problems (Institute of Medicine, 2001; Loomis, 2002). In particular, the U.S. Government has outlined a plan that seeks to ensure that most Americans have electronic health records by the year 2014 (WHSOU, 2004, 2005, 2006). The feasibility of achieving this ambitious goal is questionable (Ford et al., 2006; Ferris, 2007; McGee, 2007). Despite high expectations for the value of IT in healthcare, healthcare information technology (HIT) use in the U.S. is low in the number of adopters as well as in the extent of actual use (Johnston et al., 2002; Blumenthal et al., 2006). In this research, we are concerned with one type of HIT and one type of healthcare setting, that is, electronic medical records (EMRs)1 use among Received: 28 February 2007 Revised: 16 July 2007 2nd Revision: 3 September 2007 Accepted: 27 September 2007
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