Incentives and barriers that influence clinical computerization in Hong Kong: A population-based physician survey

Gabriel M. LEUNG, Leung Ho Philip YU, Irene O. L. WONG, Janice M. JOHNSTON, KeithY. K. TIN

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40 Citations (Scopus)

Abstract

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation.

Design and Measurements
: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation.

Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive.

Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. Copyright © 2003 American Medical Informatics Association.
Original languageEnglish
Pages (from-to)201-212
JournalJournal of the American Medical Informatics Association : JAMIA
Volume10
Issue number2
DOIs
Publication statusPublished - Mar 2003

Citation

Leung, G. M., Yu, P. L. H., Wong, I. O. L., Johnston, J. M., & Tin, K. Y. K. (2003). Incentives and barriers that influence clinical computerization in Hong Kong: A population-based physician survey. Journal of the American Medical Informatics Association : JAMIA, 10(2), 201-212. doi: 10.1197/jamia.M1202

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