Development an extended-information success system model (ISSM) based on nurses’ point of view for hospital EHRs: a combined framework and questionnaire

Abstract

Abstract Background Understanding the hospital EHR success rate has great benefits for hospitals. The present study aimed to 1-Propose an extended-ISSM framework and a questionnaire in a systematic manner for EHR evaluation based on nurses’ perspectives, 2-Determine the EHR success rate, and 3-Explore the effective factors contributing to EHR success. Methods The proposed framework was developed using ISSM, TAM3, TTF, HOT-FIT, and literature review in seven steps. A self-administrated structured 65-items questionnaire was developed with CVI: 90.27% and CVR: 94.34%. Construct validity was conducted using EFA and CFA. Eleven factors were identified, collectively accounting for 71.4% of the total variance. In the EFA step, 15 questions and two questions in EFA were excluded. Finally, 48 items remained in the framework including dimensions of technology, human, organization, ease of use, usefulness, and net benefits. The overall Cronbach’s alpha value was 93.4%. In addition, the hospital EHR success rate was determined and categorized. In addition, effective factors on EHR success were explored. Results In total, 86 nurses participated in the study. On average, the “total hospital EHR success rate” was moderate. The total EHR success rates was ranging from 47.09 to 74.96%. The results of the Kruskal–Wallis test showed that there was a significant relationship between “gender” and “self-efficacy” (p-value: 0.042). A reverse relation between “years of experience using computers” and “training” (p-value: 0.012) was observed. “Years of experience using EHR” as well as “education level” (p-value: 0.001) and “ease of use” had a reverse relationship (p-value: 0.034). Conclusions Our findings underscore the EHR success based on nurses’ viewpoint in a developing country. Our results provide an instrument for comparison of EHR success rates in various hospitals.