Digitizing Healthcase: The Ability and Motivation of Physician Practices and Their Adoption of Electronic Health Record Systems

Electronic health record systems (EHRS) are emerging as one of the most discussed and arguably controversial information technologies of the new millennium. Surprisingly, extant research has yet to examine the barriers and facilitators to widespread use of this technology. In this study, we draw upon an ability-motivation framework and self-determination theory to investigate the adoption of EHRS at the level of the physician practice. Physician practices possess a number of unique characteristics as compared with other organizational contexts, including a strong “clan” culture and a desire for autonomy. We use data from 218 physician practices from a nationwide survey to test our theoretical model. Results suggest that while the ability components exhibit direct effects on adoption, the motivational components and their relationships to adoption are more complex. Although a practice may see the value in adopting an EHRS, this intrinsic motivator can be undermined by extrinsic pressures from external sources including regulatory agencies, pharmaceutical companies as well as peer practices.