Professional Practice and Innovation: Users' Attitudes to an Electronic Medical Record System and Its Correlates: A Multivariate Analysis (Report‪)‬

Enhancing service efficiency and quality has always been one of the most important factors in heightening competitiveness in the healthcare service industry (Gillies et al. 2006; Gold, Glynn & Mueser 2006). With the increase in the demand for high quality medical services, the need for an innovative Hospital Information System (HIS) has become essential (Yoo et al. 2008). HIS and electronic medical records (EMR) are considered prerequisites for the efficient delivery of high quality care and instrumental to the decrease in medical errors in healthcare delivery (Wang et al. 2003; Lium, Tjora & Faxvaag 2008). It is widely acknowledged that the EMR has the potential to become the core electronic information and communication system in the healthcare sector (Ball 2003; Haux 2006; Chang & Chang 2008). The EMR eliminates the need for handwritten records, hence reducing time spent on record-keeping by doctors and other healthcare staff, which in turn results in reduced patient waiting time (Cimino et al. 2002). In addition, tracking time on historically-related records is also reduced simply by accessing the computerised medical records through the integrated computerised central system (Sharda et al. 2006). EMRs may also increase both patient satisfaction and financial savings (Sittig, Kuperman & Fiskio 1999). With the assumption that that EMR system can improve both the quality and effectiveness of the healthcare delivery, many healthcare provider organisations in developed countries have invested in the development and deployment of such systems (Lium et al. 2006). However, in many developing countries the EMR system is not widely disseminated or implemented. Published literature shows low adoption and high failure rate of successful EMR implementations (Southon, Sauer & Dampney 1999; Benson 2002; Ball 2003; Littlejohns, Wyaat & Garvican 2003; Ash et al. 2004). Van der Meijden et al. (2003) identified user resistance as one of the primary factors for unsuccessful EMR implementation. Despite their potential advantages, implementation of EMR systems may be resisted if users are not satisfied with the system (Van der Meijden et al. 2003). Although there is evidence of immediate benefit (Berg et al. 1998) and the improvements in time efficiency (Poissant et al. 2005), other factors, such as deficiencies in users' computer skills (Dansky et al. 1999; Van der Meijden et al 2001; Ammenwerth et al. 2003) and the implementation process (Southon et al. 1999; Aarts, Doorewaard & Berg 2004; Berg 1999), also had a negative impact on successful EMR implementation.