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A Delphi Study on Developing a Conceptual Framework to Understand the Perception of Iranian Physicians Towards Electronic Health Records

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Part of the book series: Healthcare Delivery in the Information Age ((Healthcare Delivery Inform. Age))

Abstract

The aim of this study is to design a verified set of questions, which help the future studies to evaluate and identify factors, which might influence Iranian physician’s perception towards EHR. Conceptual framework is developed and the Delphi method is used to analyse the validity of the questionnaire. Appropriateness of items in the framework was defined and validated through content validity index for items (I-CVI). In total, 18 questions have been modified from the first round of Delphi study. All items achieved CVI over 78 % for both confidence and importance for the second round with overall S-CVI of confidence and importance being 93 % and 92 %, respectively.

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References

  • Al-Gahtani, S. S., Hubona, G. S., et al. (2007). Information technology (IT) in Saudi Arabia: Culture and the acceptance and use of IT. Information Management, 44(8), 681–691.

    Article  Google Scholar 

  • Al-Gahtani, S. S., & King, M. (1999). Attitudes, satisfaction and usage: Factors contributing to each in the acceptance of information technology. Behaviour and Information Technology, 18(4), 277–297.

    Article  Google Scholar 

  • Ammenwerth, E., Mansmann, U., et al. (2003). Factors affecting and affected by user acceptance of computer-based nursing documentation: Results of a two-year study. Journal of the American Medical Informatics Association, 10(1), 69–84.

    Article  PubMed  Google Scholar 

  • Ash, J. S., & Bates, D. W. (2005). Factors and forces affecting EHR system adoption: Report of a 2004 ACMI discussion. Journal of the American Medical Informatics Association, 12(1), 8–12.

    Article  PubMed  Google Scholar 

  • Ash, J. S., Gorman, P. N., et al. (2004). Computerized physician order entry in U.S. hospitals: Results of a 2002 survey. Journal of the American Medical Informatics Association, 11(2), 95–99.

    Article  PubMed  Google Scholar 

  • Axtell, C., Wall, T., et al. (2002). Familiarity breeds content: The impact of exposure to change on employee openness and well-being. Journal of Occupational and Organizational Psychology, 75(2), 217–231.

    Article  Google Scholar 

  • Bakhtiar, A. (2007). Ahmadinejad’s achilles heel: The Iranian economy. Payvand Iran News. Retrieved August 6, 2011, from http://www.payvand.com/news/07/jan/1295.html

  • Barki, H., & Hartwick, J. (1994). Measuring user participation, user involvement, and user attitude. MIS Quarterly, 18(1), 59–82.

    Article  Google Scholar 

  • Brookstone, A. (2004). Electronic medical records: Creating the environment for change. British Columbia Medical Journal, 46(5), 233–235.

    Google Scholar 

  • Charles, F., Southon, G., et al. (1996). Information technology in complex health services organizational impediments to successful technology transfer and diffusion. Journal of the American Medical Informatics Association, 4(2), 112–124.

    Google Scholar 

  • Cherry, B., Carter, M., et al. (2008). Factors affecting electronic health record adoption in long-term care facilities. Journal for Healthcare Quality, 30(2), 37–47.

    Article  PubMed  Google Scholar 

  • Chin, T. (2003). Doctors pull plug on paperless system. Retrieved September 17, 2011, from http://www.ama-assn.org/amednews/2003/02/17/bil20217.htm

  • Dansky, K. H., Gamm, L. D., Vasey, J., & Barsukiewicz, C. (1999). Electronic medical records: Are physicians ready?/Practitioner application. Journal of Healthcare Management, 44(6), 440–454; discussion 454–455.

    PubMed  CAS  Google Scholar 

  • Davis, F. D. (1993). User acceptance of information technology: System characteristics, user perceptions and behavioral impacts. International Journal of Man-Machine Studies, 38(3), 475–487.

    Article  Google Scholar 

  • Doolan, D., Bates, D., et al. (2002). The use of computers for clinical care: A case series of advanced U.S. sites. American Medical Informatics Association.

    Google Scholar 

  • Edwards, N., Kornacki, M. J., et al. (2002). Unhappy doctors: What are the causes and what can be done? British Medical Journal, 324(7341), 835–838.

    Article  PubMed  Google Scholar 

  • Eid, R. (2009). Extending TAM and IDT to predict the adoption of the internet for B-to-B marketing activities: An empirical study of UK companies. International Journal of E-Business Research, 5(4), 18.

    Article  Google Scholar 

  • Eschenburg, F., Lylykangas, J., et al. (2005). User acceptance: The BioSec approach. Biometric Technology Today, 13(7), 8–10.

    Article  Google Scholar 

  • FanYun, P., & Huang, K. (2010). Applying the technology acceptance model to the introduction of healthcare information systems. Technological Forecasting and Social Change, 78(4), 650–660.

    Google Scholar 

  • Ford, E. W., Menachemi, N., et al. (2005). Predicting the Adoption of electronic health records by physicians: When will health care be paperless? Journal of the American Medical Informatics Association, 13(1), 106–112.

    Article  PubMed  Google Scholar 

  • Ford, E. W., Menachemi, N., et al. (2009). Resistance is futile: But it is slowing the pace of EHR adoption nonetheless. Journal of the American Medical Informatics Association, 16(3), 274–281.

    Article  PubMed  Google Scholar 

  • Francis, L. P. (2010). The physician-patient relationship and a National Health Information Network. The Journal of Law, Medicine & Ethics, 38(1), 36–49.

    Article  Google Scholar 

  • Friedman, C., Elstein, A., et al. (1999). Enhancement of clinicians’ diagnostic reasoning by computer-based consultation. Journal of the American Medical Association, 282(19).

    Google Scholar 

  • Gans, D., Kralewski, J., Hammons, T., & Dowd, B. (2005). Medical groups’ adoption of electronic health records and information systems. Health Affairs, 24(5), 1323–1333.

    Article  PubMed  Google Scholar 

  • Garibaldi, R. A. (1998). Computers and the quality of care—A clinician’s perspective. The New England Journal of Medicine, 338(4), 259–260.

    Article  PubMed  CAS  Google Scholar 

  • Griffith, J. R., & White, K. R. (2005). The revolution in hospital management. Journal of Healthcare Management, 50(3), 170–189.

    PubMed  Google Scholar 

  • Guo, C. (2009). A cross cultural validation of perceptions and use of social network service: An exploratory study (pp. 42–50). An exploratory study. M. S. University, ProQuest.

    Google Scholar 

  • Hajavi, A., Azar, F., et al. (2005). Medical records standards in selected countries and Iran: A comparative study. Institute of Health Record & Information Management, 46(1).

    Google Scholar 

  • Harrison, B., & Ralphs, D. (2001). How best to organise acute hospital services? British Medical Journal, 323(7324), 1305.

    Article  PubMed  CAS  Google Scholar 

  • Ives, B., & Olson, M. H. (1984). User involvement and mis success: A review of research. Management Science, 30(5), 586–603.

    Article  Google Scholar 

  • Jarvenpaa, S. L., & Ives, B. (1991). Executive involvement and participation in the management of information technology. MIS Quarterly, 15(2), 205–227.

    Article  Google Scholar 

  • Johnson, C. M., Johnson, T. R., et al. (2005). A user-centered framework for redesigning health care interfaces. Journal of Biomedical Informatics, 38(1), 75–87.

    Article  PubMed  Google Scholar 

  • Karahanna, E., & Straub, D. W. (1999). The psychological origins of perceived usefulness and ease-of-use. Information & Management, 35(4), 237–250.

    Article  Google Scholar 

  • Kazemi, A., Ellenius, J., et al. (2009). CPOE in Iran–A viable prospect?: Physicians’ opinions on using CPOE in an Iranian teaching hospital. International Journal of Medical Informatics, 78(3), 199–207.

    Article  PubMed  Google Scholar 

  • Kujala, S. (2003). User involvement: A review of the benefits and challenges. Behaviour and Information Technology, 22(1), 1.

    Article  Google Scholar 

  • Lapointe, L., & Rivard, S. (2006). Getting physicians to accept new information technology: Insights from case studies. Canadian Medical Association Journal, 174(11).

    Google Scholar 

  • Lim, C. L. (2004). Race, multi-cultural accommodation and the constitutions of Singapore and Malaysia. Singapore Journal of Legal Studies, 117–149.

    Google Scholar 

  • Linstone, H., & Turoff, M. (1975). The Delphi method: Techniques and applications. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Lorenzi, N. M., Kouroubali, A., et al. (2009). How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings. BMC Medical Informatics and Decision Making, 9(1).

    Google Scholar 

  • Lorenzi, N., & Riley, R. (1995). Organizational aspects of health informatics: Managing technological change. California: Springer.

    Book  Google Scholar 

  • Lowry, G. (2002). Modelling user acceptance of building management systems. Automation in Construction, 11(6), 695–705.

    Article  Google Scholar 

  • Lucas, H. C. (1976). The implementation of computer-based models. New York: National Association of Accountants.

    Google Scholar 

  • MacEachern, M. T. (1957). Hospital organization and management. Chicago: Physicians’ Record Co.

    Google Scholar 

  • Maidani, Z., Safdari, R., et al. (2006). Comparative study on the establishment’s approach to information management standards (E-Health). Hormozgan Health Journal, 167–172.

    Google Scholar 

  • Mead, D., & Moseley, L. (2001). The use of the Delphi as a research approach. Nurse Researcher, 8(4), 4–23.

    Article  Google Scholar 

  • Meade, B., Buckley, D., et al. (2009). What factors affect the use of electronic patient records by Irish GPs? International Journal of Medical Informatics, 78(8), 551–558.

    Article  PubMed  Google Scholar 

  • Menachemi, N. (2006). Barriers to ambulatory EHR: Who are ‘imminent adopters’ and how do they differ from other physicians? Informatics in Primary Care, 14(2), 101–108.

    PubMed  Google Scholar 

  • Miller, V. D., Johnson, J. R., et al. (1994). Antecedents to willingness to participate in a planned organizational change. Journal of Applied Communication Research, 22(1), 59–80.

    Article  Google Scholar 

  • Ming-Chi, L. (2009). Factors influencing the adoption of internet banking: An integration of TAM and TPB with perceived risk and perceived benefit. Electronic Commerce Research and Applications, 8(3), 130–141.

    Article  Google Scholar 

  • Moghaddasi, H., Hosseini, A., et al. (2006). A new model for the organizational structure of the medical records. Perspectives in Health Information Management., 3, 4.

    PubMed  Google Scholar 

  • Morrissey, J. (2004). CHW plans IT initiative. Modern Healthcare, 34(8), 16.

    Google Scholar 

  • Morton, M. E. P. R., & Wiedenbeck S. (2010). EHR acceptance factors in ambulatory care: A survey of physician perceptions. Perspectives in Health Information Management, (1559–4122), 1–17.

    Google Scholar 

  • MRC. (2010). Evaluation of electronic health record in Iran. Retrieved September 17, 2011, from http://www.majlis.ir/mhtml/index.php?newlang=english

  • Nair, S. V. (2011). Benefits and security of electronic health record (EHR) use by pediatric staff: A technology acceptance model (TAM)-based quantitative study (p. 112). Minnesota: School of Business and Technology, Capella University.

    Google Scholar 

  • Okoli, C., & Pawlowski, S. D. (2004). The Delphi method as a research tool: An example, design considerations and applications. Information Management, 42(1), 15–29.

    Article  Google Scholar 

  • Overhage, M., Perkins, S., Tierney, W. M., & McDonald, C. J. (2001). Controlled trial of direct physician order entry: Effects on physicians. Time utilization in ambulatory primary care internal medicine practices. Journal of the American Medical Informatics Association, 8(4), 361–371.

    Article  PubMed  CAS  Google Scholar 

  • Purvis, R. L., Sambamurthy, V., et al. (2001). The assimilation of knowledge platforms in organizations: An empirical investigation. Organization Science, 12(2), 117–135.

    Article  Google Scholar 

  • Robey, D. (1979). User attitudes and management information system use. Academy of Management Journal, 22(3), 527–538.

    Article  Google Scholar 

  • Rouibah, K., H. I. Hamdy, et al. (2009). Effect of management support, training, and user involvement on system usage and satisfaction in Kuwait. Industrial Management & Data Systems, 109(3), 338–356. Bingley: Emerald Group

    Google Scholar 

  • Saarinen, T. (1996). An expanded instrument for evaluating information system success. Information Management, 31(2), 103–118.

    Article  Google Scholar 

  • Sharma, R., & Yetton, P. (2003). The contingent effects of management support and task interdependence on successful information systems implementation. MIS Quarterly, 27(4), 533–555.

    Google Scholar 

  • Smith, R. (2001). Why are doctors so unhappy? British Medical Journal, 322(7294), 1073–1074.

    Article  PubMed  CAS  Google Scholar 

  • Straub, D., Keil, M., et al. (1997). Testing the technology acceptance model across cultures: A three country study. Information Management, 33(1), 1–11.

    Article  Google Scholar 

  • Teo, T., Sing, C. C., et al. (2008). A cross-cultural examination of the intention to use technology between Singaporean and Malaysian pre-service teachers: An application of the technology acceptance model (TAM). Educational Technology & Society, 11(4), 265–280.

    Google Scholar 

  • van der Meijden, M. J., Tange, H., et al. (2001). Development and implementation of an EPR: How to encourage the user. International Journal of Medical Informatics, 64(2–3), 173–185.

    Article  PubMed  Google Scholar 

  • Vanessa, E., & Donald D. (1997). The role of culture in interface acceptance. In Proceedings of the IFIP TC13 international conference on human-computer interaction. London: Chapman Hall.

    Google Scholar 

  • Venkatesh, V., Morris, M. G., et al. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27(3), 425–478.

    Google Scholar 

  • Walsham, G. (2002). Cross-cultural software production and use: A structurational analysis. MIS Quarterly, 26(4), 359–380.

    Article  Google Scholar 

  • Winkelman, W. J., & Leonard, K. J. (2004). Overcoming structural constraints to patient utilization of electronic medical records: A critical review and proposal for an evaluation framework. Journal of the American Medical Informatics Association, 11(2), 151–161.

    Article  PubMed  Google Scholar 

  • Young, G. J., Charns, M. P., et al. (2001). Top manager and network effects on the adoption of innovative management practices: A study of TQM in a public hospital system. Strategic Management Journal, 22(10), 935–951.

    Article  Google Scholar 

  • Zhang, J. (2005). Human-centered computing in health information systems. Part 1: Analysis and design. Journal of Biomedical Informatics, 38(1), 1–3.

    Article  PubMed  Google Scholar 

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Correspondence to Seyed Mohammad Seyedi Alavi .

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Alavi, S.M.S., Win, K.T. (2014). A Delphi Study on Developing a Conceptual Framework to Understand the Perception of Iranian Physicians Towards Electronic Health Records. In: Wickramasinghe, N., Al-Hakim, L., Gonzalez, C., Tan, J. (eds) Lean Thinking for Healthcare. Healthcare Delivery in the Information Age. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8036-5_10

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