Assessing differences between physicians' realized and anticipated gains from electronic health record adoption

Area of Science:

• Health Informatics
• Health Services Research
• Information Systems

Background:

• Return on investment (ROI) is a key factor influencing the adoption of Electronic Health Records (EHRs).
• Physician reliance on early adopter experiences shapes future technology adoption patterns.
• Understanding physician perceptions of EHR value streams is critical for addressing adoption barriers.

Purpose of the Study:

• To map the value streams defining EHR ROI calculations.
• To compare perceived EHR value streams between current users and intended adopters.
• To identify similarities, differences, and governing constructs in EHR value perceptions.

Main Methods:

• Survey data collected from 1,772 physicians by the Texas Medical Association.
• Bayesian Belief Network Modeling used to construct EHR value streams.
• Comparative analysis of value stream perceptions between current EHR users and intended adopters.

Main Results:

• Current EHR users and intended adopters exhibit significantly different perceptions of the EHR value stream.
• Intended adopters' value stream shows complex interrelationships, while current users perceive a simpler, linear relationship.
• Current users identify 'Reduced Medical Records Costs' as the primary value driver, whereas intended adopters focus on 'Reduced Charge Capture Costs'.

Conclusions:

• Physician assessments of EHR benefits differ qualitatively and significantly between current users and intended adopters.
• Addressing the distinct value perceptions of intended adopters is essential for promoting wider EHR adoption.
• The identified differences in value streams highlight the need for tailored strategies to maximize EHR ROI and overcome adoption hurdles.