What Do Electronic Health Record Vendors Reveal About Their Products: An Analysis of Vendor Websites

Purchasing electronic health record (EHR) systems is a process in which potential buyers and users often seek and assess information about the products in question and compare alternatives. EHR is often a new technology to the people who use it, introducing new ways of performing clinical and administrative tasks. As such, it may be regarded as an innovation. Rogers’ [1] diffusion of innovations theory suggests that the process of adopting innovations (the innovation decision process) typically follows five stages: knowledge, persuasion, decision, implementation, and confirmation. Most relevant to this work is the knowledge stage in which adopters learn about the existence of an innovation (awareness knowledge), gain basic knowledge of how to use it (how-to knowledge), and understand the underlying principles behind it (principles knowledge). This is followed by the persuasion stage, in which potential adopters actively seek more information about the innovation, evaluate its characteristics, form positive or negative attitudes toward it, and subsequently adopt (eg, purchase) or reject the innovation at the decision stage.

For EHRs, the adoption decision process involves a planning phase that includes needs assessment, identifying champions, gaining buy-in from stakeholders, workflow analysis, understanding financial issues, and goal setting [2,3]. This is followed by a system selection phase in which information is sought from various sources including vendors and general consultants[4], visits to practices that have installed systems of interest, and product demonstrations [2,3]. At this stage, according to Lorenzi et al [3], “the internet provides a valuable source of information regarding specific EHR system products, capabilities, and the selection process” (p.8). In particular, vendor websites could play an important role in making an adoption decision by creating awareness, providing how-to and principle knowledge, and using various persuasive means to affect potential adopters’ perceptions of EHRs. However, to the best of our knowledge, no systematic efforts have been made to examine whether EHR vendors use their websites to present the information typically gathered in the pre-decision stages of Rogers’ innovation-decision process.

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