Information systems and healthcare XXXIII: An institutional theory perspective on physician adoption of electronic health records

Abstract

With the recent legislation providing financial incentives to physicians who acquire electronic health record systems, we will be afforded an opportunity to study incentivized adoption of technology coupled with the threat of future penalties for non-adoption. This research uses institutional theory to propose factors that are expected to influence the adoption of electronic health records (EHRs) by independent physician practices in the coming years. The study presents a model describing the role of coercive, mimetic, and normative forces on adoption intent. Payer incentives/penalties as well as dominant healthcare delivery partners will exert coercive pressures on physician practices. Additionally, since physicians identify with their own specialties, it is expected that they will also be subject to mimetic forces resulting from successful adoption by similar specialists, particularly given their concerns about expected benefits from these systems. Finally, normative forces resulting from the successful interoperation of electronic health records among regional providers should influence physician adoption. The ability to partner with other physicians and healthcare providers or vendors adopting the same system should increase individual practice adoption intent in the presence of coercive, mimetic, and/or normative forces. © 2010 by the authors.