Healthcare Professionals’ Resistance Behaviors to Electronic Medical Record System (EMRs) Implementation: Equity Theory and Psychological Reactance Theory Perspectives

Abstract

Electronic medical record (EMR) system which records patients’ entire consulting and diagnostic information on electronic basis can not only provide hospital sufficient information but also enable physicians to make accurate disease diagnoses effectively Chang et al (2012) and Lehmann et al (2015) indicated that most of the hospital’s medical record system is in the early to medium phase and healthcare professional resistance behavior to adopt the system is a crucial element to hinder success Therefore this study attempts to discuss whether the healthcare professional evaluation on the hospital performance of the expected reciprocal obligation will lead to healthcare professionals’ perceived unmet promises and perceived organizational justice and results in psychological contract breach (PCB) and generated resistance behavior to EMR implementation from the perspective of equity and psychological reactance theory; furthermore to study whether the effects of healthcare professionals’ personal trait (e g personal innovativeness in IT & healthcare technology management (HTM) competency) and the hospital management practice (e g responses to resistance behavior) can potentially mitigate the healthcare professional resistance behavior By applying both qualitative and quantitative research approach 12 cases of in-depth interview was conducted with senior healthcare professionals and IT staffs to ensure the reliability of research framework and hypotheses; and develop survey questionnaire based on these outcomes Four hundred and eighty-nine valid questionnaires have been collected from healthcare professionals and IT staffs for quantitative analysis and hypotheses testing The results demonstrated that perceived unmet promises and perceived organizational justice had effect on healthcare professional PCB and generated resistance behavior to EMR implementation In term of the moderating effects acknowledgement and rectification responses approach was the most suitable method in response to the healthcare professional resistance behavior; healthcare professionals with high- or low-PIIT and high- or low-HTM competency had significantly different between groups in the effect of perceived organizational justice on PCB or the effect of perceived unmet promises and perceived organizational justice on resistance behavior to EMR implementation The study suggested that the hospital should be more concentrated on the healthcare professional negative using experience and improves it; besides the hospital should perform more transparent and respected in job and responsibility distribution and avoid giving heavy workload and responsibility to the healthcare professionals who are more capable and talented to mitigate their emotional exhaustion Finally the study suggested that the hospitals should develop a complete two-way communication mechanism to increase the understanding between the hospitals and healthcare professionals to obtain a win-win situation

Date of Award	2015 Aug 27
Original language	English
Supervisor	Hsin-Hsin Chang (Supervisor)