Propensity, Susceptibility, Infectiousness, and Proximity: Predicting Organizational Diffusion of Electronic Medical Records

Posted: 25 Sep 2008

See all articles by Corey M. Angst

Corey M. Angst

IT, Analytics, and Operations department

Ritu Agarwal

University of Maryland - Robert H. Smith School of Business

Vallabh Sambamurthy

Michigan State University - Department of Accounting & Information Systems

Date Written: June 12, 2008

Abstract

Electronic medical record systems (EMRs) could alleviate many problems confronting the health care industry. However, due to their inherent complexity and the difficulties in gaining commitment to their adoption by numerous stakeholders, adoption by hospitals has been slow. In this paper we use a heterogeneous diffusion model to identify predictors of the likelihood of EMR adoption by hospitals. We theorize that this likelihood is driven by static organizational characteristics as well as temporal and spatial factors. Static organizational factors describe the propensity of a hospital to adopt EMR, based on its past adoption of other related information technologies. Temporal factors reflect the fact that the adoption of EMR spreads through the community of hospitals overt time and that an individual hospital's likelihood of adoption is shaped by susceptibility and infectiousness factors. Susceptibility refers to the fact that a particular non-adopter hospital is likely to adopt EMR because it is vulnerable, by virtue of its age and size, to the adoption actions of other hospitals. At the same time, infectiousness suggests that a particular non-adopter hospital might also adopt EMR because of exposure to actions of an adopter firm that has "celebrity" status. In addition, spatial proximity (i.e., physical distance to other adopters) and social proximity (i.e., membership in a health system with other adopters) are also expected to influence the probability of EMR adoption by a hospital. We use a discrete event survival model fitted to data from a sample drawn from a multi-year survey, spanning 1970 to 2005, of almost 4,000 hospitals across the USA to test the hypotheses. Results provide support for the proposed relationships between propensity, susceptibility, infectiousness, and proximity and the likelihood of EMR adoption. Theoretical and practical implications are discussed.

Keywords: electronic medical record, diffusion, propensity, susceptibility, infectiousness, spatial proximity

Suggested Citation

Angst, Corey M. and Agarwal, Ritu and Sambamurthy, Vallabhajosyula, Propensity, Susceptibility, Infectiousness, and Proximity: Predicting Organizational Diffusion of Electronic Medical Records (June 12, 2008). Available at SSRN: https://ssrn.com/abstract=1273057

Corey M. Angst (Contact Author)

IT, Analytics, and Operations department ( email )

348 Mendoza College of Business
University of Notre Dame
Notre Dame, IN 46556-5646
United States

Ritu Agarwal

University of Maryland - Robert H. Smith School of Business ( email )

College Park, MD 20742-1815
United States

Vallabhajosyula Sambamurthy

Michigan State University - Department of Accounting & Information Systems ( email )

270 North Business Complex
East Lansing, MI 48824-1034
United States

Register to save articles to
your library

Register

Paper statistics

Abstract Views
720
PlumX Metrics