Understanding how social influence and social networks affect EMR implementation

描述（由申请人提供）：健康信息技术（IT），特别是电子病历（EMR）形式，越来越被认为是提高患者安全和护理质量的重要工具。尽管EMR有潜力改善个人的健康和提供者的表现，但由于实施工作失败，许多医疗保健组织无法实现EMR系统的预期效益。理论和实践表明，社会影响可能在推动或阻碍执行进程方面发挥关键作用。然而，有一个缺乏研究，探讨谁是有影响力的，以及医疗从业者如何影响彼此的新技术的使用。为了应对这一紧迫的差距，在文献中，本研究的目的是探讨意见领袖的作用-个人认为有特别的影响力，他们的同事的信念和行动-在实施电子病历系统。使用混合方法方法，利用定量（即，调查）和定性（即，访谈和观察）的方法，拟议的工作需要收集一个大型学术医院的六个临床单位在一年的时间跨度的主要数据。使用在三个时间点（实施前六个月，实施后一个月，实施后六个月）收集的调查数据，该研究的第一个目的是确定意见领袖，并评估个人层面的预测谁被认为是一个意见领袖在实施过程中。使用相同的调查数据，本研究的第二个目的是估计意见领袖在多大程度上影响他们的同事的看法和使用的电子病历系统。本研究的第三个目的是通过访谈和观察来确定意见领袖用来支持或抵制实施工作的具体行为和策略。这项工作的结果将促进对社会影响力在EMR实施中的作用的理解，并提供如何利用具有高度影响力的个人来说服其他人接受EMR，并最终更有效地使用EMR的见解。

DESCRIPTION (provided by applicant): Health information technology (IT), particularly in the form of electronic medical records (EMRs), is increasingly recognized as an important tool for improving patient safety and quality of care. Despite the potential of EMRs to improve the health of individuals and the performance of providers, many healthcare organizations have not been able to realize the intended benefits of EMR systems because of failed implementation efforts. Theory and practice suggest that social influence may play a critical role in enabling - or hindering - the implementation process. However, there is a paucity of research that examines who is influential and how healthcare practitioners influence one another's use of new technology. In response to this pressing gap in the literature, the objective of this study is to examine the role of opinion leaders - individuals perceived as having particular influence on the beliefs and actions of their colleagues - during the implementation of an EMR system. Using a mixed methods approach that leverages both quantitative (i.e., surveys) and qualitative (i.e., interviews and observations) methods, the proposed work entails collecting primary data for six clinical units in one large academic hospital over a one year time-span. Using survey data collected at three time points (six months pre-implementation, one month post-implementation, six months post-implementation), the first aim of the study is to identify opinion leaders and to assess individual-level predictors of who is perceived to be an opinion leader over the course of the implementation process. Using the same survey data, the second aim of the study is to estimate the extent to which opinion leaders influence their colleagues' perceptions and use of the EMR system. The third aim of the study is to use interviews and observations to identify specific behaviors and strategies that opinion leaders use to generate support or resistance for implementation efforts. The findings from this work will advance understanding of the role of social influence in EMR implementation and provide insight into how to leverage highly influential individuals to convince others to embrace EMRs, and ultimately, to use EMRs more effectively.