Explaining physicians' acceptance of EHCR systems: An extension of TAM with trust and risk factors

This paper explains physicians' acceptance, in terms of usage intentions, of a central component of health information technology: electronic health care records (EHCR systems). For this purpose, the original version of the Technology Acceptance Model (TAM), which included perceived usefulness, perceived ease of use, attitude towards usage, and usage intentions, is extended with trust and risk-related factors such as physicians' perceptions of institutional trust, perceived risk, and information integrity. The results stress the special importance of attitudinal factors (attitude towards usage and perceived institutional trust) and cognitive instrumental processes (mainly, usefulness perceptions) in determining physicians' intention to use EHCR systems. Perceptions of institutional trust exerted strong direct effects on physicians' perceived usefulness, perceived ease of use, and attitude towards the use of EHCR systems. In addition, trust fully mediated the influences of perceived risk and information integrity perceptions on physicians' acceptance of EHCR systems. (C) 2010 Elsevier Ltd. All rights reserved.