title: Exploring physicians' extended use of electronic health records (EHRs): A social influence perspective.
abstract: BACKGROUND
  Once electronic health records (EHRs) have been fully implemented and integrated into the daily work of a healthcare organisation/hospital, there is considerable pressure on management to demonstrate the benefits that these systems can deliver to the organisation. One practical way to maximise the value and highlight the benefits of EHRs is to encourage physicians to increase and extend their use of EHR functions.
  
  
  OBJECTIVE
  This study used a social influence theory context to examine the impact of mechanisms of social influence on the intentions of physicians to extend their use of EHRs.
  
  
  METHODS
  A survey of physicians (n = 205) in a first-class comprehensive hospital in southern China was conducted approximately 2 years after the hospital's introduction of EHRs. A 16-item questionnaire was developed to measure the impact of four social influence factors (reward, punishment, social image and group norm) on physicians' intentions to extend their use of EHRs. The research model included two additional control variables (perceived usefulness and perceived ease of use) to account for potential covariance among social influence measures.
  
  
  RESULTS
  The study's research model showed significant relationships between physicians' responses on two of the social influence measures (rewards and group norm) and their intentions to extend their use of EHRs. Punishment and social image measures did not influence physicians' intentions to increase their use of EHRs.
  
  
  CONCLUSIONS
  These findings have suggested that for healthcare organisations to maximise the benefits of EHRs, the efforts of hospital management should be directed towards rewarding those physicians who increase their use of EHRs; and to promoting and reinforcing the increased usage of EHRs among physicians as a group norm.
authors.affiliation: Xi'an Jiaotong University, Peoples Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.affiliation: Xi'an Jiaotong University, Peoples Republic of China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Xi'an University of Architecture and Technology, Peoples Republic of China.
authors.forename: Jinglei
authors.initials: J
authors.lastname: Sun
authors.affiliation: The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Peoples Republic of China taideng258@sina.com.
authors.forename: Guangquan
authors.initials: G
authors.lastname: Zhou
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D002681:China; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D010820:Physicians / Q000523:psychology*; D012927:Social Control, Informal; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: China; computer system evaluation; electronic health records; health information management; hospital information system; physicians; utilization