An exploratory study of factors affecting adoption of technology by small physician practices

Most prior research on the adoption of a nationwide electronic health record and the exchange of health data has focused on large, sophisticated healthcare institutions and on the benefits to be realized once the nationwide electronic health record is in place and data have been compiled and aggregated. Little attention has been paid to the challenges for small physician practices in implementing such a complex system. This is significant because these practices serve a large proportion of the population and failure to address this issue could lead to an increase in the disparity in access to healthcare. The purpose of this study was to examine the challenges faced by these small physician practices in implementing the electronic health record. The research question sought to learn how to mitigate these challenges in order to encourage implementation of the electronic health record. A qualitative, exploratory, single-case study was conducted informed by the conceptual frameworks of open systems theory and the adoption of innovation. Data were collected by examining extant, peer-reviewed literature obtained from books, journals, and industry-related websites and searching databases based on key words and phrases. Data were analyzed for commonalities and grouped into themes, and axial coding was used to identify sub-categories and to pinpoint the core category. Findings were that policy changes should include additional methods of integration and revised quality measures based on comparing metrics from similar practices. As more small physician practices integrate into the electronic health record system, the implications for social change are that the quality of healthcare may increase, especially for the uninsured and the low-income population.