The Effects of Creating Psychological Ownership on Physicians' Acceptance of Clinical Information Systems

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The Effects of Creating Psychological Ownership on Physicians’ Acceptance of Clinical Information Systems

Pare Guy, Sicotte Claude, Jacques Helene

J Am Med Inform Assoc. 2006 Mar/Apr

Introduction Physician resistance to CIS has been common in new systems implementations. The authors look at physician acceptance of clinical information systems, and propose a new construct called psychological ownership they derive from related literature in human development, psychology and sociology. Psychological ownership refers to a feeling of possessiveness and of being tied to the object. This construct gives insights into the conditions under which individuals form beliefs and react to change leading to positive or negative orientations toward the change.

Methods The authors conducted a review of the literatures and also a mail in survey for a POE implemented in a community health network characterized by strong acceptance. They used the constructs of perceived usefulness and perceived ease of use to review IT acceptance behaviors and determine how these influence attitudes.

Results The feelings of ownership toward the system and to a lesser extend perceived ease of use had significant and positive effects on the extent to which physicians perceived the CIS to be useful. The results also show that communication and overall responsibility are the most important precursors of psychological ownership. Contrary to their expectations, the data show that hands on activities did not have significant effect on the development of ownership.

Conclusion Recognition that major challenges to CIS success are often behavioral and an understanding of psychological ownership allows for managerial interventions that can increase the physicians acceptance of CIS. In order to foster physicians’ adoption of a CIS it is important to encourage and cultivate a positive attitude and feelings of ownership through active physician participation in the development process. The authors give several examples of activities throughout the software development lifecycle that increase a sense of responsibility and encourage physician adoption of ownership feelings. These include an investment of time and effort by the physicians in hardware and software selection, cost benefit analysis, project leadership, and end user training. Continuous project communications should focus on the clinical utility of the CIS and how the system can improve effectiveness, instead of simply the steps to use the system.

The authors recognize limitations to their study including the need to complete multi-method measurements. They also understand the need to do an examination of an implementation during the development process and immediately following the go live, rather than simply the retrospective study they conducted, and they recommend further testing against recent project failures.