Assessing health information technology acceptance: Developing a human-computer interaction activity-centered acceptance framework

Developing solutions and methods to simplify work complexities is one of the most important goals that healthcare informaticians strive to achieve. Therefore, various forms of health information technology (HIT) are often implemented for this very purpose. However, end-user acceptance is one dynamic that can stifle the success of an implemented HIT. Consequently, several frameworks have been devised to assess end-user acceptance. Despite these efforts, there is an absence of human-computer interaction (HCI) theoretical frameworks that offer a holistic perspective, meaning one that accounts for sociotechnical and sociocultural environmental changes.;In order to fill this gap, a three-phase research design (guided by the Activity Theory), was applied to develop an electronic health record systems (EHR) end-user acceptance framework. In Phase I, healthcare professionals identified acceptance concepts and created a social cognitive map to model their perceptions of EHR acceptance. In Phase II, online surveys were administered to refine the cognitive map. In Phase III, Phase I participants reconvened to develop recommendations to improve EHR end-user acceptance.;The self-reported perceptions of acceptance from Phase I suggested that there are 11 concepts that influence EHR acceptance: accessibility, efficiency, effectiveness, ease of use, privacy, sharability, mandated usage, perceived usefulness, safety, learnability, and use behavior. Furthermore, the created social cognitive map asserted that safety, sharability, effectiveness, mandated usage, accessibility, and ease of use, all impact EHR efficiency, while learnability is positively influenced by ease of use. In Phase II, results suggested that the end-users' role (ancillary, administrative, and clinical), level of experience with EHRs, and gender influences perceptions of acceptance. In Phase III, participants indicated that the most important concepts of EHR acceptance are accessibility, efficiency, effectiveness, ease of use, and privacy. Additionally, participants suggested that EHR adopters can improve acceptance by establishing rapport with end-users, standardizing training procedures, assessing end-user attributes, and evaluating EHR customizability, technical infrastructure, and its ability to support data exchange. In summary, improving EHR acceptance requires an evaluation of the sociotechnical and sociocultural environment. Failing to evaluate these environmental elements can impede acceptance and successful HIT implementations.