An organizational learning perspective on the assimilation of electronic medical records among small physician practices

Small physician practices play an essential role in the healthcare delivery system but are least likely to adopt health information technologies such as electronic medical records (EMRs). Factors contributing to low adoption include investment cost, productivity loss, and lack of financial incentives. However, these factors do not explain why some small practices, which face similar challenges nonetheless assimilate EMRs, while others do not. We investigated the assimilation of EMRs from the theoretic perspective of organizational learning in a survey of small physician practices and evaluated whether characteristics associated with organizational learning barriers are related to EMR assimilation. We found that learning-related scale, related knowledge, and diversity were positively associated with small physician practices' stage of assimilation of EMR technology. Our findings suggest that some small practices are able to overcome the substantial learning barriers presented by EMRs but that others will require support to develop sufficient learning capacity. We consider implications for practice from this research and areas requiring further research.