Electronic medical records (EMRs) are recognized as an important tool for improving patient safety and quality of care. Despite their potential, many health care organizations have not realized the intended benefits of EMRs because of implementation failures. Prior research suggests that implementation failures, which occur when individuals use EMRs less frequently or consistently than required to achieve potential benefits, can be attributed to managerial factors such as poor project planning or difficulties with the design and use of the technology. Although less is known about the role of social influence in EMR implementation, theory and practice suggest that social influence may play a critical role in enabling or hindering the implementation process.
According to social influence theory, clinicians tend to adopt new practices when influenced by their colleagues’ use of an innovation. In practice, the importance of social influence is evidenced by industry-wide recommendations to engage opinion leaders—defined as individuals perceived as having significant influence on the beliefs and actions of their colleagues—to overcome resistance and increase staff buy-in. Despite the portended importance of social influence, however, there is a dearth of literature on how to use social influence processes to persuade health care practitioners to embrace new technology, and ultimately use it more effectively.
The objective of Ms. Yuan’s AHRQ-funded dissertation study is to use a mixed methods approach to examine the role of opinion leaders during the implementation of an EMR at six clinical units in a large academic hospital over a 1-year period. For the quantitative approach, surveys will be administered before and after the implementation of an EMR to identify opinion leaders and estimate the extent to which they influence colleagues’ perceptions and use of the EMR. The qualitative approach will use interviews and observation to understand how influential individuals exercise influence to encourage or discourage use of EMRs.
The aims of this research are to:
- Identify opinion leaders and assess individual-level predictors of who is perceived to be an opinion leader in the implementation of an EMR system over time.
- Estimate the extent to which opinion leaders influence their colleagues’ perceptions and use of an EMR system.
- Identify and describe the specific behaviors and strategies through which opinion leaders influence others in the implementation of an EMR system.
The overall goal of this study is to advance the understanding of the role of social influence in EMR implementation to improve EMR adoption and the effective use of EMRs.
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