Dansky KH et al. 1999 "Electronic medical records: are physicians ready?"

Reference
Dansky KH, Gamm LD, Vasey JJ, et al. Electronic medical records: are physicians ready? Practitioner application. J Healthc Manag 1999;44(6):440.
Abstract
"The use of electronic medical records [EMR] in healthcare organizations will require substantial changes in the way physicians and their staffs provide patient care. A study identifies specific attitudes or factors that should be targeted before implementing an EMR project, and demonstrates empirical support for a model of perceived usefulness of EMR. It was found that computer experience, computer anxiety, and perceptions of organizational support predict the degree to which physicians and mid-level practitioners view the effort positively. Strategies for the successful management of EMR implementation include engaging the physicians and practitioners in computer activities prior to implementation and providing strong organizational support before and during the redesign effort. The use of electronic medical records (EMR) in healthcare organizations will require substantial changes in the way physicians and their staff provide patient care. This study is the first part of a larger study assessing factors that influence successful implementation of EMR in ambulatory care settings. The purposes of this study were to identify specific attitudes or factors that should be targeted before implementing an EMR project, and demonstrate empirical support for a model of perceived usefulness of EMR. We found that computer experience, computer anxiety, and perceptions of organizational support predict the degree to which physicians and mid-level practitioners view the EMR effort positively. Strategies for the successful management of EMR implementation include engaging the physicians and practitioners in computer activities prior to implementation and providing strong organizational support before and during the redesign effort. Acceptance of EMR by physicians and their support staff is essential if computerization is to be successful, yet anecdotal reports of resistance and negative attitudes are frequently reported. Empirical studies indicate that physicians have not yet embraced this technology. As part of strategic planning and deployment of a computerized patient record, attitudes of end-users must be assessed. Using an integrative framework from the job design literature and management information sciences, we propose that multiple factors influence attitudes toward EMR, offer a conceptual model of end-user acceptance, and present findings from an empirical test of our model."
Objective
(1) "To identify specific attitude or factors that should be targeted for successful EMR implementation" and (2) to "demonstrate empirical support for the predictors of perceived usefulness model."
Size
Small, medium and large
Geography
Urban
Other Information
The participant's "sample was pooled from five private medical practices, nine group medical practices that are part of HMO, and a university-based health center." All sites of these medical practices were in Pennsylvania.
Type of Health IT
Electronic medical records (EMR)
Context or other IT in place
Practices participating in the study did not have EMR systems in place.
Workflow-Related Findings
"We found that physicians who value a close patient relationship have less positive attitudes about the EMR."
"The mean for perceived usefulness...was 3.47, reflecting a neutral to slightly positive attitude overall about the perceived benefits of the EMR."
"Results showed that computer experience and organizational support were positive predictors of percieved [EHR] usefulness and computer anxiety and valuing a close patient relationship were negative predictors."
"[F]emale gender, not owning a computer, and few or no years of computer use were positively and significantly correlated with computer anxiety, but that age was not significantly correlated with computer anxiety"
Study Design
Other
Study Participants
The study participants included 67 physicians and 18 clinicians (nurse practitioners and physician assistants).