This paper considers the adoption of Health Information Technology (HIT) by physician clinics with ten or fewer physicians. The paper considers the theoretical economics literature on technology adoption for a new technology and has a place in the empirical tests of these models. The two major hypotheses tested in the paper are that the probability of adopting HIT increases with the number of physicians working at the clinic and if the clinic is part of a chain of clinics, and that it also increases with increased competition at the market level measured by the number of clinics per 10,000 residents in a county. To test these hypotheses, the paper first estimates a baseline logit model followed by three hazard rate models. In each case, clinic size is found to have positive though not significant effect on the probability of adoption (in the logit model) or to decrease the predicted time to adoption for the clinic (in the hazard rate models), being in a chain of clinics is found to have a strong positive and significant on the probability of adoption, and increased competition is found to have a positive though not significant effect on the probability of adoption.

The purpose of this study was to assess nurse and medical assistant perceived needs prior to implementing an expended web-based training (WBT) program in physician clinics. This case study was conducted with a mixed-data approach using quantitative and descriptive survey data collection. A total of 239 nurses and medical assistants within the Trinity Mother Frances Hospitals and Clinics dispersed throughout east, north east and north central Texas participated. The participants shared knowledge and behaviors common to the culture of the organization. When new and existing clinical staff traveled to the distant primary campus for training, the operations of the clinic practice was disrupted. Employees are not hired in groups comprising convenient training class sizes, and mandatory training often cannot wait until a class is of a cost effective size. The data were collected using a 50-item survey evaluating computer access, computer usage, computer knowledge (satisfaction, frustration, and motivation to transfer learning), and WBT preference (employee's support and employee's perception of supervisor's support). Quantitative data were collected in the form of a dichotomous yes or no and ordinal data from two Likert type scales. Descriptive survey data was collected using open-ended questions emphasizing perceived strengths, weaknesses, opportunities and threats (SWOT) of WBT. Demographic data were collected to facilitate comparison of perspectives based on demographic information gathered. To support reliability and validity of the Clinic WBT Needs Assessment (CWBTNA), exploratory factor analysis, Cronbach's coefficient alpha, and correlations were utilized to validate the survey instrument. Chi-squares, ANOVAs, and t-tests were conducted. Following the Bonferroni control for Type I error rate (a), four t-test, two chi-squares, and three ANOVAs demonstrated significance. Descriptive responses generated from descriptive survey items were transcribed into an Excel spreadsheet which allowed coding and sorting. Themes consistent with order sets of the quantitative survey emerged. Among additional findings, statistical data demonstrated that staff perceived they transferred learning into the work place best when they perceived greater supervisor support. All findings are detailed in the document.