The Autonomy-Control Dilemma: Motivation, Ability and the Adoption of Electronic Health Record Systems by Physician Practices

Posted: 25 Sep 2008

See all articles by Abhay Mishra

Abhay Mishra

affiliation not provided to SSRN

Ritu Agarwal

University of Maryland - Robert H. Smith School of Business

Catherine Anderson

affiliation not provided to SSRN

Corey M. Angst

IT, Analytics, and Operations department

Date Written: July 21, 2008

Abstract

The lack of timely and relevant patient information has been frequently linked to adverse treatment outcomes; hence the effective management of patient information has emerged as a strategic imperative for the healthcare industry. Healthcare informatics experts have suggested that electronic health record (EHR) systems can facilitate effective information sharing within and between healthcare stakeholders such as physician practices, hospitals, insurance companies, and laboratories. In this paper, we examine the adoption of EHRs at the level of the physician practice. Physician practices occupy a central position in the healthcare value-chain and possess a number of unique characteristics that differentiate them from other institutional contexts, including a strong "clan" culture, a potent professional and occupational identity, and a desire for autonomy. We draw upon the motivation-ability framework and self-determination theory from organizational behavior and psychology to theorize about the determinants of EHR adoption in physician practices. We use data from 218 physician practices, spread across the United States, to test our theoretical model. Results suggest that while the ability components exhibit direct effects on adoption, the motivational components and their relationships to adoption are more nuanced. Although practices may recognize that there is value associated with adopting EHRs, this motivation can be undermined by influences from external sources. Theoretical and pragmatic implications of the findings are discussed.

Keywords: Electronic Health Record System, EHR, Ability, Motivation, Motivation-Ability Framework, Self Determination Theory (SDT), Adoption, Physician Practices, Health IT

Suggested Citation

Mishra, Abhay and Agarwal, Ritu and Anderson, Catherine and Angst, Corey M., The Autonomy-Control Dilemma: Motivation, Ability and the Adoption of Electronic Health Record Systems by Physician Practices (July 21, 2008). Available at SSRN: https://ssrn.com/abstract=1273149

Abhay Mishra

affiliation not provided to SSRN ( email )

Ritu Agarwal

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

College Park, MD 20742-1815
United States

Catherine Anderson

affiliation not provided to SSRN ( email )

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

Register to save articles to
your library

Register

Paper statistics

Abstract Views
682
PlumX Metrics