HIT 9 KEY FACTORS INFLUENCING THE ADOPTION OF EMR IN TAIWAN HOSPITAL

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1 HIT 9 KEY FACTORS INFLUENCING THE ADOPTION OF EMR IN TAIWAN HOSPITAL JU-LING HSIAO 1, HSIN-GINN HWANG 2 CHIA-NAN UNIVERSITY OF PHARMACY AND SCIENCE 1 NATIONAL CHIAO TUNG UNIVERSITY 2 1

2 Introduction Since 2000, the Department of Health has promoted the development of EMR in the country. Success of the development of EMR requires not only aggressive planning and promotion on the part of the government, but also investigation of the problems and difficulties for their development from the standpoint of hospitals and medical institutes. 2

3 Research Objectives The purpose of this study is to identify the factors influencing Electronic Medical Records (EMR) adoption and barrier to implement. 3

4 Theoretical Foundation - TOE Technology- Organization- Environment Rogers (1983) indicated that the characteristics of organizational leaders, the internal structure of the organization, and the external characteristics of the organization will influence the adoption and expansion of innovative technologies. On the basis of argumentations made by Rogers (1983), Tornatzky and Fleischer (1990) investigated organizations developing large information systems, and with continuous use of the Technology Organization Environment (TOE) as a research model, they examined decisions with effects on the introduction of information technologies. 4

5 EMR characteristics Relative advantage Compatibility Complexity Research Framework Environmental factors Policies and regulations Peer competitive EMR Adoption Organizational factors Organizational resources Ability of project teams Users participations 5

6 Research design (1/2) Instrument A survey methodology using a 44-item structured questionnaire (each item was measured by a five-point Likert scale) Sample and Setting The paper covers hospitals at regional levels and medical center, and it considers the promotion of EMR for its 2010 top contenders in the special section of the Department of Health. Data collections of top managers (President, Vice President, Supervisors of Information Departments, or Chairman of Promotion of EMR) on the promotion of EMR in hospitals 6

7 Research design (2/2) Data analysis 116 questionnaires were sent out and 80 copies were obtained (68.9% response rate) The demographic data of respondents were: 45 surveys came from the President and Vice President of hospitals (56.2%), 35 came from Supervisors of Information Departments (43.8%), 15 came from medical centers (18.7%), and 65 came from regional hospitals (81.2%). Collected data were analyzed using the PLS approach Validity and Reliability The CR values were found to be 0.731~0.933 (> 0.6) The AVE values were 0.572~0.834 (>0.5) 7

8 Research Hypothesis testing and Structural Model Tests of the structural model are mainly based upon the estimated path coefficient and the value of R 2. The value of R 2 on the entire model is The explanation ability of the model is 47.9%. 8

9 Hypotheses The result of hypotheses testing H 1.1 : The relative advantage of the EMR has positive effects on the adoption of EMR H 1.2 : The compatibility of the EMR has positive effects on the adoption of EMR Path Coefficients 0.377** 0.228* H 1.3 : The complexity of the EMR has negative effects on the adoption of EMR H 2.1 : The policies and regulations has positive effects on the adoption of EMR H 2.2 : The peer competitive has positive effects on the adoption of EMR H 3.1 : The organizational resources has positive effects on the adoption of EMR H 3.2 : The ability of project teams has positive effects on the adoption of EMR H 3.3 : The users participations has positive effects on the adoption of EMR *P<0.05, **P<0.01 9

10 Structural Model The value of R 2 on the entire model is The explanation ability of the model is 47.9%. The research model proposed in the paper, after being tested empirically, shows a considerable degree of reliability and validity, and the explanation ability of the overall model is 47.9% (R 2 = 0.479) 10

11 Barrier to implement EMR According to the weights, the prior three barriers which impact on the development of EMR in hospital are: 1. The privacy protection concerns of the patient; 2. The difficulty in medical informatics staff training; 3. The difficulty to maintain information security. 11

12 Discussions According to the data analysis: (1) there is a significant influence on the development of EMR in hospitals from its innovative characteristics, where the relative advantage (0.377**) and compatibility (0.228*) of the EMR show significant influence on hospitals development of EMR 12

13 The innovative characteristics of EMR significantly affect adoption by hospitals The relative advantage of these records is improvement of competitiveness and work performance for the organizations and strengthening of the efficiency and quality of patient care. Consequently, it is important to the development of EMR in hospitals. In addition, the compatibility of EMR is an important consideration when applying technology in organizations. If a high degree of compatibility between technology and the original hospital information system exists and can be incorporated into work processes, work effectiveness will be increased accordingly. 13

14 Barrier for Developing Electronic Medical Records(1/2) The barrier to developing EMR(2011) are concern for the protection privacy rights of the patients difficulty training medical informatics professionals problems with the maintenance of information security undeveloped laws and regulations difficult access for mature technologies unclear policies 14

15 Conclusion Promoting EMR is an international trend, and the key to success for carrying out health-policy goals for holistic healthcare and for the complete planning of the promotion of an EMR system is cooperation between overall concepts and policies Identifying the key factors and obstacles affecting the development of EMR to meet with the efforts and direction of improvements made by the government can achieving a winwin situation for the promotion of the records between the industry and the government 15

16 Conclusion Our paper provides basic information for the assessment of the promotion of EMR, which can be used as a reference for comparison analysis of this promotion between the past and the future. Establishing overall patterns for the development of EMR in the country allows comparison of its development with other countries, allowing reduction of opposition to its promotion to permit effective implementation of the vision of u-healthcare. 16

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