Healthc Inform Res.  2014 Jul;20(3):183-190. 10.4258/hir.2014.20.3.183.

Factors Affecting Electronic Medical Record System Adoption in Small Korean Hospitals

Affiliations
  • 1Health Insurance Review & Assessment Research Institute, Health Insurance Review & Assessment Service, Seoul, Korea.
  • 2Department of Economics, Sungkyunkwan University, Seoul, Korea. leejinh@skku.edu

Abstract


OBJECTIVES
The objective of this paper is to investigate the factors affecting adoption of an Electronic Medical Record (EMR) system in small Korean hospitals.
METHODS
This study used survey data on adoption of EMR systems; data included that from various hospital organizational structures. The survey was conducted from April 10 to August 3, 2009. The response rate was 33.5% and the total number of small general hospitals was 144. Data were analyzed using the generalized estimating equation method to adjust for environmental clustering effects.
RESULTS
The adoption rate of EMR systems was 40.2% for all responding small hospitals. The study results indicate that IT infrastructure (OR, 1.48; 95% CI, 1.23 to 1.80) and organic hospital structure (OR, 1.86; 95% CI, 1.07 to 3.23) rather than mechanistic hospital structure or the number of hospitals within a county (OR, 1.08; 95% CI, 1.01 to 1.17) were critical factors for EMR adoption after controlling for various hospital covariates.
CONCLUSIONS
This study found that several managerial features of hospitals and one environmental factor were related to the adoption of EMR systems in small Korean hospitals. Considering that health information technology produces many positive health outcomes and that an 'adoption gap' regarding information technology exists in small clinical settings, healthcare policy makers should understand which organizational and environmental factors affect adoption of EMR systems and take action to financially support small hospitals during this transition.

Keyword

Medical Informatics; Health Information Technology; Electronic Medical Record; Electronic Health Record

MeSH Terms

Administrative Personnel
Delivery of Health Care
Electronic Health Records*
Hospitals, General
Humans
Medical Informatics

Cited by  1 articles

Association between Electronic Medical Record System Adoption and Healthcare Information Technology Infrastructure
Youn-Tae Lee, Young-Taek Park, Jae-Sung Park, Byoung-Kee Yi
Healthc Inform Res. 2018;24(4):327-334.    doi: 10.4258/hir.2018.24.4.327.


Reference

1. Lee Y, Chang H. Ubiquitous health in Korea: progress, barriers, and prospects. Healthc Inform Res. 2012; 18(4):242–251.
Article
2. Park RW, Shin SS, Choi YI, Ahn JO, Hwang SC. Computerized physician order entry and electronic medical record systems in Korean teaching and general hospitals: results of a 2004 survey. J Am Med Inform Assoc. 2005; 12(6):642–647.
Article
3. Yoo S, Lee KH, Lee HJ, Ha K, Lim C, Chin HJ, et al. Seoul National University Bundang Hospital's Electronic System for Total Care. Healthc Inform Res. 2012; 18(2):145–152.
Article
4. Yoon D, Chang BC, Kang SW, Bae H, Park RW. Adoption of electronic health records in Korean tertiary teaching and general hospitals. Int J Med Inform. 2012; 81(3):196–203.
Article
5. National Alliance for Health Information Technology. Report to the office of the National Coordinator for Health Information Technology on defining key health information technology terms. Washington (DC): National Coordinator for Health Information Technology;2008.
6. Wang SJ, Middleton B, Prosser LA, Bardon CG, Spurr CD, Carchidi PJ, et al. A cost-benefit analysis of electronic medical records in primary care. Am J Med. 2003; 114(5):397–403.
Article
7. Bates DW, Ebell M, Gotlieb E, Zapp J, Mullins HC. A proposal for electronic medical records in U.S. primary care. J Am Med Inform Assoc. 2003; 10(1):1–10.
Article
8. Pohl J. A partnership for clinician electronic health record use and quality of care. Okemos (MI): Michigan Public Health Institute;2011.
9. Lee J, McCullough JS, Town RJ. The impact of health information technology on hospital productivity. Rand J Econ. 2013; 44(3):545–568.
Article
10. Lee J, Dowd B. Effect of health information technology expenditure on patient level cost. Healthc Inform Res. 2013; 19(3):215–221.
Article
11. Lee J, Kuo YF, Goodwin JS. The effect of electronic medical record adoption on outcomes in US hospitals. BMC Health Serv Res. 2013; 13:39.
Article
12. Park YT. Impact of task, structure, and environment on electronic health record adoption, use, and interoperability in hospitals [dissertation]. Minneapolis (MN): University of Minnesota;2010.
13. Jha AK, DesRoches CM, Kralovec PD, Joshi MS. A progress report on electronic health records in U.S. hospitals. Health Aff (Millwood). 2010; 29(10):1951–1957.
Article
14. DesRoches CM, Campbell EG, Rao SR, Donelan K, Ferris TG, Jha A, et al. Electronic health records in ambulatory care: a national survey of physicians. N Engl J Med. 2008; 359(1):50–60.
Article
15. Yu S, Yoo S, Min W. A survey on current status of computerization of physician office practice in Korea. J Korean Soc Med Inform. 2003; 9(3):323–330.
Article
16. Shields AE, Shin P, Leu MG, Levy DE, Betancourt RM, Hawkins D, et al. Adoption of health information technology in community health centers: results of a national survey. Health Aff (Millwood). 2007; 26(5):1373–1383.
Article
17. Gans D, Kralewski J, Hammons T, Dowd B. Medical groups' adoption of electronic health records and information systems. Health Aff (Millwood). 2005; 24(5):1323–1333.
Article
18. Fiks AG, Alessandrini EA, Forrest CB, Khan S, Localio AR, Gerber A. Electronic medical record use in pediatric primary care. J Am Med Inform Assoc. 2011; 18(1):38–44.
Article
19. Fleming NS, Culler SD, McCorkle R, Becker ER, Ballard DJ. The financial and nonfinancial costs of implementing electronic health records in primary care practices. Health Aff (Millwood). 2011; 30(3):481–489.
Article
20. McClellan SR, Casalino LP, Shortell SM, Rittenhouse DR. When does adoption of health information technology by physician practices lead to use by physicians within the practice? J Am Med Inform Assoc. 2013; 20(e1):e26–e32.
Article
21. Terry AL, Brown JB, Bestard Denomme L, Thind A, Stewart M. Perspectives on electronic medical record implementation after two years of use in primary health care practice. J Am Board Fam Med. 2012; 25(4):522–527.
Article
22. Lee J, Cain C, Young S, Chockley N, Burstin H. The adoption gap: health information technology in small physician practices. Understanding office workflow can help realize the promise of technology. Health Aff (Millwood). 2005; 24(5):1364–1366.
Article
23. Burns T. The management of innovation. London: Tavistock Publications;1961.
24. Aiken M, Hage J. The organic organization and innovation. Sociology. 1971; 5(1):63–82.
Article
25. Meadows IS. Organic structure and innovation in small work groups. Hum Relat. 1980; 33(6):369–382.
Article
26. Health Insurance Review & Assessment Service. 2005 Hospital information technology survey. Seoul, Korea: Health Insurance Review & Assessment Service;2005.
27. Hull F, Hage J. Organizing for innovation: beyond Burns and Stalker's organic type. Sociology. 1982; 16(4):564–577.
Article
28. Kwon ST. A study on the effects of strategy, competencies, organizational structure and their interactions on the performance of hospitals [dissertation]. Seoul, Korea: Yonsei University;2003.
29. Child J. Organization: contemporary principles and practice. Malden (MA): Blackwell Publishing;2005.
30. Wikipedia Foundation Inc. Herfindahl index [Internet]. [place unknown]: Wikipedia Foundation Inc.;c2014. cited at 2014 Jul 1. Available from: http://en.wikipedia.org/wiki/Herfindahl_index.
31. Smith T, Smith B. PROC GENMOD with GEE to analyze correlated outcomes data using SAS. San Diego (CA): Department of Defense Center for Deployment Health Research, Naval Health Research Center;2006.
Article
32. SAS Institute Inc. SAS/STAT(R) 9.2 user's guide, second edition [Internet]. Cary (NC): SAS Institute Inc.;c2014. cited at 2014 Jul 1. Available from: http://support.sas.com/documentation/cdl/en/statug/63033/HTML/default/viewer.htm#statug_genmod_sect057.htm.
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