Impact of Electronic Health Records on Job Characteristics and Job Satisfaction of Physicians in Punjab

Abstract

The Indian economy has become one of the fastest growing economies in the world. The Indian market has become extremely competitive after a few years of effectuation of liberalization, privatization and globalization. Technological advancements in the last few years have thrown up fresh possibilities for improving efficiencies and effectiveness of business activities. Innovative technologies in fields related to information and communication management can lead to business excellence. Healthcare sector in India started investing in information technology (IT) in early 1990s. IT was initially used for financial services and support billing. Later, the role of IT got enhanced in managing laboratory, pharmacy and radiology services. EHR technology was introduced to capture electronic information about a patient’s mental, physical and social state over his/her lifetime. The technology also started recording health conditions of patients in primary, secondary or tertiary care. In summary, EHR technology is digitalization of medical history and current information of patients. The scope of present study has been limited to Punjab’s multispecialty hospitals using EHR technology. The healthcare sector, for the purpose of this study, refers to multispecialty healthcare service providers of Punjab that provide tertiary-care services. The sector and the state have been selected on grounds of a technology-focused environment, familiarity of the researcher and easy access to respondents. The study focuses on physicians working in multispecialty hospitals in Punjab. The study identifies critical factors leading to success in implementation of EHR technology. Factors related to data management in the post-implementation phase of usage of EHR technology have also been identified. The impact of critical success factors and factors of data management on job characteristics and job satisfaction of physicians has then been analyzed. A pre-tested, structured and non-disguised questionnaire has been used to gather data from 280 physicians. Statistical tools like exploratory factor analysis, multiple regression analysis and chi-square tests have been applied. Five ‘critical success factors’ related to the implementation phase of EHR, namely, ‘training’, ‘acceptance to change’, ‘organizational support’, ‘software attributes’ and ‘computer knowledge’, have been identified. Two CSFs, namely, ‘computer knowledge’ and ‘software attributes’ have been found to be making a significant contribution in the impact on job characteristics of physicians. Four CSFs, namely, ‘training’, ‘computer knowledge’, ‘acceptance to change’ and ‘organizational support’ have been observed to be making a significant impact on levels of job satisfaction of clinicians. In the post-implementation phase of usage of EHR technology, four factors of ‘data management’, namely, ‘effectiveness’, ‘accessibility’, ‘accuracy’ and ‘timeliness’, have been identified. Three factors, namely, ‘accessibility’, ‘effectiveness’ and ‘timeliness’ have been seen to be making a significant impact on job characteristics of physicians. Two factors related to data management, namely, ‘accessibility’ and ‘timeliness’ have been found to be making a significant impact on their levels of job satisfaction. The study has attempted to provide insight to the hospitals using EHR technology, and also to the ones which are planning to adopt this technology. Recommendations to the hospital administration with respect to speedy achievement of success in adoption of EHR technology have been made. The study should be useful to hospital administrators in understanding behavior of physicians towards technology. It is also expected to help them in enhancing the overall effectiveness of health care initiatives. The study should also help in improving satisfaction levels of physicians