Electronic Health Record (EHR) Organizational Change: Explaining Resistance Through Profession, Organizational Experience, and EHR Communication Quality

Abstract

The American Recovery and Reinvestment Act passed by the U.S. government in 2009 mandates that all healthcare organizations adopt a certified electronic health record (EHR) system by 2015. Failure to comply will result in Medicare reimbursement penalties, which steadily increase with each year of delinquency. There are several repercussions of this seemingly top-down, rule-bound organizational change-one of which is employee resistance. Given the penalties for violating EHR meaningful use standards are ongoing, resistance to this mandate presents a serious issue for healthcare organizations. This study surveyed 345 employees in one healthcare organization that recently implemented an EHR. Analysis of variance results offer theoretical and pragmatic contributions by demonstrating physicians, nurses, and employees with more experience in their organization are the most resistant to EHR change. The job characteristics model is used to explain these findings. Hierarchical regression analyses also demonstrate the quality of communication surrounding EHR implementation-from both formal and informal sources-is negatively associated with EHR resistance and positively associated with perceived EHR implementation success and EHR's perceived relative advantage.

Nurses’ Experience With Health Information Technology: Longitudinal Qualitative Study

“…Previous research indicates that clinician satisfaction with HIT is mixed, which may be related to clinical documentation practice, workload, and productivity [ 45 ]. Physicians have reported dissatisfaction with template-based HIT documentation [ 45 ], possibly due to their high autonomy needs to prioritize work tasks [ 46 ]. In the current study, nurses also expressed dissatisfaction with template-based physical assessment because documentation was not streamlined.…”

“…A qualitative study that aimed to understand physicians’ and nurses’ experience with EHRs found no major perceived differences based on profession [ 48 ]. A commonality among all professions appears to be the need for communication when implementing new HIT [ 46 ].…”

Forecasting the Maturation of Electronic Health Record Functions Among US Hospitals: Retrospective Analysis and Predictive Model

“…Later, personal computers came with many preinstalled applications so that consumers could start using their new machines “out-of-the-box.” The net effect is that state-of-the-art information platforms’ minimum feature sets encompass multiple generations of earlier innovations as a technology matures. It is likely that EHR vendors followed a similar pattern of increased technological sophistication as a matter of normal business prior to 2006 [ 43 ].…”

Multifaceted Contents and Techniques for Designing Health Communication Courses

“…A leader in this realm, Lupton (1994) promoted theoretical and methodological practices for interrogating the power dynamics inherent to health-related issues. Meanwhile, the cybernetic tradition attends to organizational and systemic dynamics, such as those occurring in online social support groups (Wright, 2016) and healthcare organizations (Barrett, 2018). Those teaching from a phenomenological perspective seek understanding of how persons live and articulate their health experiences.…”