Leadership styles and EMR adoption: insights from Bali's primary care clinics

This study aims to explore the influence of leadership styles, using full-range leadership theory (FRLT), and technology acceptance, guided by the technology acceptance model (TAM), on the implementation of electronic medical records (EMRs) in primary care settings in Bali.

Using a mixed-methods approach, this research analyzes data from 120 primary care clinics in Bali with a total of 1,204 respondents. Quantitative data were collected through structured surveys assessing leadership styles and EMR acceptance, supplemented by qualitative insights from 30 interviews and 6 focus group discussions. Statistical methods, including the Chi-Square Test of Independence and pairwise comparisons using adjusted residuals, were used to examine the relationships between leadership styles, EMR adoption, perceived usefulness and ease of use.

The Chi-Square Test of Independence revealed a significant association between leadership style and EMR adoption level (χ² = 30.33, p < 0.001). Transformational leadership was strongly associated with higher full EMR adoption rates, while Laissez-Faire leadership showed a significant association with no EMR adoption. Qualitative data supported these findings, emphasizing the critical role of proactive, supportive leadership in enhancing technology acceptance.

This study uniquely integrates FRLT and TAM within the context of EMR adoption in Bali's health-care system, providing new insights into how leadership and technology perceptions interact to influence implementation outcomes in a diverse health-care environment.