The Role of Electronic Health Records in Enhancing and Threatening Physician Identities: An Identity Theory Perspective

With the lack of timely and relevant patient information increasingly being linked to adverse medical outcomes, effective management of patient data has emerged as a strategic imperative for the healthcare industry. Healthcare informatics experts have suggested that electronic health record systems (EHRS) can facilitate effective information sharing within and between healthcare stakeholders such as physician practices, hospitals, insurance companies, and laboratories. In this paper, we examine the adoption and use of EHRS in medical practices. Physician practices occupy a central position in the healthcare value-chain and possess a number of unique characteristics that differentiate them from other institutional contexts, including a strong “clan” culture, potent professional identities, and a desire for autonomy. We draw upon social identity theory and self-categorization theory to examine how the nature of impending changes engendered by EHRS can enhance or threaten physicians’ social identities, and influence decision-making regarding its adoption and use. We use data from 206 physician practices, spread across the United States, to test our theoretical model. Results suggest that while careprovider identity reinforcement and professional identity reinforcement positively impact the adoption and use of EHRS, professional identity deterioration and governmental influence impact them negatively, and careprovider identity deterioration has no significant impact on them. Theoretical and pragmatic implications of the findings are discussed.