Title: Understanding electronic health records resistance: a revealed causal mapping approach

Authors: Bahae Samhan; K.D. Joshi

Addresses: College of Business, Department of Accounting and Business Information Systems, Illinois State University, Normal, IL 61761, USA ' Carson College of Business Department of Management, Information Systems, and Entrepreneurship, Washington State University, Pullman, Washington, 99163, USA

Abstract: The implementation of electronic health records (EHR) has potential benefits to healthcare organisations. However, evidence show that EHR systems are being resisted by healthcare providers. Little research in IS has addressed this phenomenon. To understand EHR resistance, a mid-range theory is evoked from our textual analysis of responses gathered from healthcare providers at a large international hospital. The data were analysed using revealed causal mapping technique (RCM). The results revealed that EHR resistance is comprised of seven major constructs: costs, benefits, perceived value, perceived threat, organisational support, self-efficacy, and system circumvention availability. Additionally, this study also uncovered the underlying concepts that are shaping each of these constructs. This study demonstrated that the use of the RCM methodology yielded concepts and constructs of EHR resistance that are not suggested by generalised theory. The use of RCM also revealed the main interactions and linkages between these constructs.

Keywords: EHRs; electronic health records; EHR resistance; HIT; health information technology; RCM; revealed causal mapping; EMR; electronic medical records; URM; user resistance model; costs; benefits; perceived value; perceived threat; organisational support; self-efficacy; system circumvention.

DOI: 10.1504/IJEH.2017.083163

International Journal of Electronic Healthcare, 2017 Vol.9 No.2/3, pp.100 - 128

Received: 18 Jul 2016
Accepted: 27 Nov 2016
Published online: 21 Mar 2017 *

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