title: Improving performance in medical practices through the extended use of electronic medical record systems: a survey of Canadian family physicians.
abstract: BACKGROUND
  Numerous calls have been made for greater assimilation of information technology in healthcare organizations in general, and in primary care settings in particular. Considering the levels of IT investment and adoption in primary care medical practices, a deeper understanding is needed of the factors leading to greater performance outcomes from EMR systems in primary care. To address this issue, we developed and tested a research model centered on the concept of Extended EMR Use.
  
  
  METHODS
  An online survey was conducted of 331 family physicians in Canadian private medical practices to empirically test seven research hypotheses using a component-based structural equation modeling approach.
  
  
  RESULTS
  Five hypotheses were partially or fully supported by our data. Family physicians in our sample used 67% of the clinical and 41% of the communicational functionalities available in their EMR systems, compared to 90% of the administrative features. As expected, extended use was associated with significant improvements in perceived performance benefits. Interestingly, the benefits derived from system use were mainly tied to the clinical support provided by an EMR system. The extent to which physicians were using their EMR systems was influenced by two system design characteristics: functional coverage and ease of use. The more functionalities that are available in an EMR system and the easier they are to use, the greater the potential for exploration, assimilation and appropriation by family physicians.
  
  
  CONCLUSIONS
  Our study has contributed to the extant literature by proposing a new concept: Extended EMR Use. In terms of its practical implications, our study reveals that family physicians must use as many of the capabilities supported by their EMR system as possible, especially those which support clinical tasks, if they are to maximize its performance benefits. To ensure extended use of their software, vendors must develop EMR systems that satisfy two important design characteristics: functional coverage and system ease of use.
authors.affiliation: Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Raymond
authors.affiliation: Chair in Information Technology in Health Care, HEC Montréal, 3000, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada. guy.pare@hec.ca.
authors.forename: Guy
authors.initials: G
authors.lastname: Paré
authors.affiliation: Chair in Information Technology in Health Care, HEC Montréal, 3000, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada.
authors.forename: Ana
authors.initials: A
authors.lastname: Ortiz de Guinea
authors.affiliation: Université du Québec à Montréal, Montréal, Canada.
authors.forename: Placide
authors.initials: P
authors.lastname: Poba-Nzaou
authors.affiliation: Chair in Information Technology in Health Care, HEC Montréal, 3000, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Trudel
authors.affiliation: Université Laval, Québec City, Canada.
authors.forename: Josianne
authors.initials: J
authors.lastname: Marsan
authors.affiliation: Chair in Information Technology in Health Care, HEC Montréal, 3000, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Micheneau
mesh_terms: D000328:Adult; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards; D019538:Health Care Surveys; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D010821:Physicians, Family / Q000592:standards*; D011331:Private Practice / Q000592:standards*; D011792:Quebec