NON-ACCEPTANCE OF ELECTRONIC MEDICAL/HEALTH RECORDS SYSTEM

NON-ACCEPTANCE OF ELECTRONIC MEDICAL/HEALTH RECORDS SYSTEM 

1.    Introduction

This study is based on the Technology Acceptance Model (TAM). The expectation of the study is to identify an information technology system, which was not accepted by people, and to identify the reasons for such non-acceptance by using TAM.

The information technology system selected as rejected by people, particularly by Medical Practitioners, is the ‘Electronic Medical/Health Records System’ and this study elaborates the reasons as to why the Electronic Medical/Health Records System was rejected by Doctors, by means of TAM.

2.    Theoretical Review

Technology Acceptance Model (TAM) is a theoretical framework that explains and predicts the user acceptance of information technology. It suggests that when users encounter a new information system innovation there are two main factors which will influence how and when they will use it.

One is Perceived Usefulness (PU), i.e., the degree to which a person believes that using a particular system would enhance his or her job performance. The other is Perceived Ease of Use (PEOU), i.e., the degree to which a person believes that using a particular system would be free from effort.

3.    Electronic Medical/Health Records System

Electronic Medical/health Records is a computerized medical information system, which collect, store and display patients’ information or an electronic record of health related information of individuals.

Traditionally health records of patients are paper based that involved with large amount of papers. Many shortcomings are there with this paper based medical records, such as, requirement of unnecessary space for document keeping, the possibility of missing important records, inability to maintain uniform record system, misinterpretations, repetition of same tests, wastage of resources and time etc.

On the other hand Electronic Medical/health Records system facilitates patients’ health and safety, quality of care instant availability of information, prompt identification of the illness, convenience treatment, save of money and resources, quick services, reduction of errors, improvement of communication of information to Doctors etc. which benefits both the patients as well as medical practitioners.

Though there are many advantages of the Electronic Medical/health Records system, medical practitioners are not willing to accept the implementation of the same.

4.    Reasons for non-acceptance of Electronic Medical/Health Records System

In this scenario, based on the TAM model, the reasons for non-acceptance of emerging technology, that is, Electronic Medical/Health Records System, are assessed mainly based on two assumptions;

            Perceived usefulness (PU)

            Perceived ease of use (PEOU)

4.1 Reasons for non-acceptance of Electronic Medical/Health Records System due to lack of Perceived usefulness:

§  More time consuming –

Medical Practitioners are supposed to spend more time when using an Electronic Medical/Health Records System, which they don’t prefer as it may reduce the number of patients they could treat per day. Further, more time consumption is required for data entering to the system, and getting familiarize with the system or learning.

§  Potential for mix-ups and confusion that can be frustrating, costly and even dangerous –

Though the use of Electronic Medical/Health Records System is said to be an advantage, some mistakes, errors, mix-ups of data etc, which are not only costly and frustrating but even dangerous are possible.  Thus, the Doctors as well as the patients are with some suspicion to resort to electronic records system. 

§  Compatible only with half of work but not compatible for all the work of Doctors –

 Electronic Medical/Health Records System can be used only for certain work of Doctors, but not for all the work. Therefore they are of the feeling that no point of moving to an electronic system that supports only few of their functions.

§  Possibility of fraudulent billing –

Parties can intentionally engage in malpractices such as generation of fraudulent bills. Such aspects hinder the trust among the Doctors and patients about electronic system.

§  Similar to other computerized systems, electronic records are also vulnerable to crashes, errors or defects –

Crash, error or defect occurred in the electronic system can trouble the smooth happening of patient care, may be even for considerable period, which can ultimately create negative or dangerous results. Unlike other computerized systems, since the patient care is a sensitive issue much concern should be to avoid such possibilities. Disruptive acts of external parties may cause enormous troubles and damages.

§  Requirement for large amount of investment –

A Doctor having a small or medium scale patient care center may find difficultly of affording the high investment required to establish Electronic Records System. 

§  Possibility of negatively affecting the relationship between the Doctors and Patients - 

The belief among the Medical Practitioners seems to be that with the introduction of an Electronic System the communication or the relationship among the Doctors and patients will be weakened or damaged. 

§  Security or privacy concerns –

By nature humans are more concern about their security and privacy. And when moving to an electronic system one of the major worries are security and privacy.

4.2 Reasons for non-acceptance of Electronic Medical/Health Records System due to lack of Perceived ease of use:

§  Necessity to be familiar with computers / lack of technical competency of the staff –

Medical Practitioners or Physicians are relatively less familiar with computers. Thus, they resist to the Electronic Medical/Health Records System, which requires sound computer literacy to operate smoothly.   Not only Doctors, but Nurses as well as patients will have to struggle with unfamiliar screens. 

§  System complexity –

Electronic Records System is a complex one, where all parties are in need to spent considerable time to be familiarize with and understand such system, prior to starting its successful operation.

§  Requirement to totally rely on the vendor –

An Electronic Medical Records System will be designed and developed by an external third party vendor, on whom it is necessary to rely on for each and every aspect. In a certain way, some sort of a risk. Any amendments or developments identified in the electronic system can only be incorporated through the vendor.

§  Lack of managerial support -

Managerial support is an essential factor to make success an effort. Thus, the support from the management of the Medical Institutions is a must to successfully implement Electronic Medical/health Records system. Proper leadership is another compulsory factor in need.

§  Lack of belief in an Electronic Medical/health Records system –

Lack of trust or belief in the society on an Electronic Medical/health Records system is also a major hindrance to realization of such system.

 5.   CONCLUSION

                 

Despite the considerable number of advantages of implanting an Electronic Medical/health Records System, it has not been a success mainly due to external variables, divided into two as lack of perceived usefulness and lack of perceived ease of use, for which reasons are elaborated above.

As a result the attitude toward using Electronic Medical/health Records System was not favorable. Thus, the particular Electronic Medical/health Records System has not been purchased by many, which shows poor behavioral intention to use.

Ultimately the actual usage of the Electronic Medical/health Records System was very much less.

By way of avoiding or overcoming the identified reasons for lack of perceived usefulness and perceived ease of use, the actual system use of Electronic Medical/health Records System can be improved.