Electronic Medical Records Use – An Examination of Resident Physician Intentions Ken Trimmer, John Beachboard, Carla Wiggins, William Woodhouse, Idaho State University trimkenn@isu.edu , beach@isu.edu , wiggcarl@isu.edu, wdhouse@fmed.isu.edu Abstract Between 1992 and 2002, overall health care spending rose from $827 billion to about $1.6 trillion; it is projected to nearly double to $3.1 trillion in the following decade. This price tag results, in part, from advances in expensive medical technology, including new drug therapies, and the increased use of high-cost services and procedures. Many policymakers, industry experts, and medical practitioners contend that the U.S. health care system—in both the public and private sectors—is in crisis [11, p. 33]. Efforts are underway to convert all medical records from paper to electronic. This manuscript uses the Unified Theory of Acceptance and Use of Technology as a lens to interpret the responses of physicians completing their Residency in Family Medicine regarding use and adoption of Electronic Medical Record Systems (EMR). 1. Introduction The 2005 Government Accountability Office [11] report, 21st Century Challenges: Reexamining the Base of the Federal Government, was intended to identify critical issues and potential options for addressing key fiscal challenges facing the federal government. As indicated above, the GAO identified healthcare as one of the most critical issues facing federal policy makers. While primarily discussed in terms of a fiscal crisis, the GAO, Department of Health and Human Services (HHS), and academic researchers have documented a number of healthcare quality concerns [10, 8, 22, 20, 15] Among the numerous policy issues associated with the provision of US healthcare is the call for increased adoption and use of health care information technology (HIT) to address structural inefficiencies and care quality issues plaguing the US health care industry [11]. Multiple clinical and administrative benefits have been identified with the adoption of HIT generally and EMR systems specifically. Yet the health care industry remains a laggard in IT adoption relative to other industries [3]. This is germane to the purpose our study investigating the intention of physicians serving residencies to adopt electronic medical record (EMR) systems in their future medical practices. As evidenced by President George W. Bush’s promulgation of Executive Order 13335 Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator, the federal government is actively encouraging the development of “a nationwide interoperable health information technology infrastructure that: (a) Ensures that appropriate information to guide medical decisions is available at the time and place of care; (b) Improves health care quality, reduces medical errors, and advances the delivery of appropriate, evidence-based medical care; (c) Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information; (d) Promotes a more effective marketplace, greater competition, and increased choice through the wider availability of accurate information on health care costs, quality, and outcomes; (e) Improves the coordination of care and information among hospitals, laboratories, physician offices, and other ambulatory care providers through an effective infrastructure for the secure and authorized exchange of health care information; and (f) Ensures that patients' individually identifiable health information is secure and protected.” Thus, a key objective of federal policy is to achieve widespread adoption of EMR within the next 10 years [8]. The GAO reports five potentially significant barriers to HIT adoption [12] including: • Investment in IT can be costly and must compete with other investments, and depends on the organization’s ability to access capital. Proceedings of the 41st Hawaii International Conference on System Sciences - 2008 1530-1605/08 $25.00 © 2008 IEEE 1