title: The effects of organizational contextual factors on physicians' attitude toward adoption of Electronic Medical Records.
abstract: BACKGROUND
  Physicians' adoption seems to be a significant issue when comprehensive implementation of Electronic Medical Records (EMR) is considered. This study was conducted to determine the organizational contextual factors affecting physicians' adoption of EMR.
  
  
  METHODS
  This was a descriptive-analytical study in which a sample of 330 physicians working in hospitals affiliated to Tehran University of Medical Sciences was selected. Physicians' attitudes toward EMRs' adoption have been assessed by a conceptual path model of Technology Acceptance model (TAM) and organizational context variables. Collected data were analyzed by SPSS16 using regression analysis. The final model was tested by structural equation modeling (SEM) and represented by SPSS-AMOS, structural equation modeling software.
  
  
  RESULTS
  The results suggest that modified proposed conceptual path model explains about 56% of the variance of EMRs' adoption. The findings also evidenced that perceived usefulness (PU), perceived ease of use (PEOU), management support; physicians' involvement, physicians' autonomy, and the doctor-patient relationship have direct and significant effect on physicians' attitudes toward EMRs' adoption. However, training showed to have no significant effect on PU and PEOU.
  
  
  CONCLUSIONS
  The present study acknowledged that considerable part of physicians' attitude toward EMRs' adoption is controlled by organizational contextual factors. These factors should be subsequently the major concern of health organizations and health policy makers.
authors.affiliation: Department of Health Information Management, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadhiwa
authors.initials: M
authors.lastname: Abdekhoda
authors.affiliation: Department of Health Information Management, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran; Health Management and Economic Research Center, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address: Ahmadi.M@IUMS.ac.ir.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ahmadi
authors.affiliation: Department of Biomedical Statistic, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmodreza
authors.initials: M
authors.lastname: Gohari
authors.affiliation: Faculty of Library and Information Sciences, University of Tehran, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Noruzi
mesh_terms: D000328:Adult; D000465:Algorithms; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D057286:Electronic Health Records; D005260:Female; D006291:Health Policy; D006761:Hospitals; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D015233:Models, Statistical; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D012044:Regression Analysis; D012984:Software; D011795:Surveys and Questionnaires
keywords: Electronic Medical Record; Organizational contextual factors; Physician; Structural equation modeling; Technology Acceptance Model