The Rx for Electronic Healthcare Records: Time, Not Incentives

Rising healthcare costs are a significant US societal concern growing from 7.5% of GNP in 1971 to 15.3% in 2004. Likewise, the number of uninsured Americans has increased to 45.0M (Altman, 2005). The US Department of Health and Human Services estimates that a national health information network could save $140 billion per year through improved care and reduced duplication of medical tests. The heart of the proposed network is the Electronic Health Record (EHR). Despite the purported benefits, EHR remains relatively underutilized in US healthcare. To better understand this reluctance by physicians to implement technology that will arguably improve the efficiency and effectiveness of healthcare, we studied fifteen family medical practices - interviewing decision makers about their consideration of EHR technology to identify significant influences on the adoption decision. These interviews were transcribed, coded, and eventually abstracted into a conceptual model that provides a plausible explanation of the factors influencing adoption.Though the current rate of adoption is proceeding slowly, our findings reveal that under certain predictable circumstances, early career stage physicians are likely to adopt this technology. When coupled with US physician demographics, it appears that a US health information network based on EHR technology is assured. An additional contribution is the observation that adoption theories relying on use intention as a predictor of adoption appear inadequate in circumstances where the adopting user is also the purchaser of the technology. These theories tend to ignore the decision to acquire technology – the heart of the current EHR adoption