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Archives of Business Research – Vol. 11, No. 8
Publication Date: August 25, 2023
DOI:10.14738/abr.118.15354.
Singh, H. P., & Kumari, R. (2023). Digital Technologies in Healthcare Management: A Study of Influence of National Culture for
Adoption of Electronic Health Records in India and Australia. Archives of Business Research, 11(8). 206-217.
Services for Science and Education – United Kingdom
Digital Technologies in Healthcare Management: A Study of
Influence of National Culture for Adoption of Electronic Health
Records in India and Australia
Harman Preet Singh
ORCID:0000-0003-4297-0016
Department of Management and Information Systems,
College of Business Administration, University of Hail,
PO Box 2440. Ha'il – 81451, Kingdom of Saudi Arabia
Radha Kumari
School of Health Care Administration, College of
Management, Taipei Medical University, Taipei, Taiwan
ABSTRACT
In the emerging healthcare landscape, digital technologies like electronic health
records (EHRs) could play a vital role in healthcare management. While developed
nations like Australia have taken the lead in implementing EHRs, developing
nations like India, have lagged. Prior research in developing and developed
countries has mainly focused on government policy, interoperability,
standardization, security, technological infrastructure, and finance as EHR
adoption factors, but the influence of national culture has remained unexplored.
This study addresses this gap in the literature by comparing the influence of
national culture on EHR adoption in India (a developing nation) and Australia (a
developed nation). In this study, Hofstede's cultural dimensions were utilized to
determine the influence of national culture. The assessment of India revealed that
the adoption of EHRs could be influenced by the use of EHRs by respectable
healthcare providers, the commitment and support of top management, and the
education and training of healthcare managers to minimize risks connected with
the use of EHRs. On the other hand, the adoption of EHRs in Australia may be
influenced by professional involvement and discussion of the benefits of EHRs,
business profitability, timely financial outcomes, and education and training of
healthcare managers to understand the benefits of EHRs adoption.
Keywords: Australia, digital technologies, electronic health records, healthcare
management, national culture, India, technology adoption
DIGITAL TECHNOLOGIES AND HEALTHCARE MANAGEMENT
Digital technologies have brought about a dramatic revolution in the operations of
contemporary institutions and have contributed immeasurable value to business processes.
The impact of digital technologies is obvious in gadgets such as computers, laptops,
smartphones, tablets, etc., used in daily life. In the current information age, digital
technologies have supplanted conventional ones (Krishnan et al., 2010). Modern digital
technologies have remodeled data gathering, information dissemination, knowledge
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Singh, H. P., & Kumari, R. (2023). Digital Technologies in Healthcare Management: A Study of Influence of National Culture for Adoption of
Electronic Health Records in India and Australia. Archives of Business Research, 11(8). 206-217.
URL: http://dx.doi.org/10.14738/abr.118.15354
generation, and decision-making (Alhamad & Singh, 2022). Digital technologies offer vigorous
decision-making based on the knowledge acquired from new forms of data and information in
the information era (Klonoff, 2013). Information transparency is a valuable advantage of
modern technologies. Information openness promotes visibility, lessens inaccuracies, and
reduces roadblocks (Albu & Flyverbom, 2016). Information transparency reduces
unnecessary concealment and gives clarity, insights, and efficacy (Danker, 2013). Information
transparency emphasizes openness, communication, collaboration, and cooperation (Barth &
Schipper, 2008). Thus, information openness facilitates the decision-making process of
prospective consumers (Winkler, 2000). Therefore, digital technologies are employed in
finance, education, healthcare, etc.
Digital technologies are altering practices in healthcare as they facilitate the gathering of
accurate medical data by developing new instruments. They contribute to the development of
original and novel knowledge for the treatment of patients. Utilizing digital technologies
facilitates the remote transfer of patients' medical data for storage, analysis, and the
development of predictions. Thus, digital technology in healthcare has emerged as a key
facilitator of modern patient care (Klonoff, 2013). The digital health system enables medical
personnel to monitor the digital health data produced by wearable devices for patients.
Therefore, digital technologies provide the necessary information, empower individuals to
take control of their health, and assist medical professionals in providing better care.
ELECTRONIC HEALTH RECORDS
In recent years, digital healthcare technology, such as electronic health records (EHRs), has
grown in importance. An EHR stores a patient's health profile, necessary personal data, etc., in
one location (Amatayakul, 2012). EHR integrates information technologies such as electronic
medical records, medical assessment support, electronic imaging, telemedicine, etc. (Gagnon
et al., 2014). EHR collects patents data for multiple visits and stores it for the lifetime of the
patient (WHO, 2006).
EHR is regarded as crucial for enhancing patient safety and quality of healthcare (Chaudhry et
al., 2006; Raposo, 2015). EHR optimizes the documentation of patient encounters, provides
accurate and timely information to medical professionals for accurate decision-making
(Raposo, 2015), helps in the effective management of chronic diseases, improves the quality
of clinical decisions (Raposo, 2015), facilitates the exchange of current information among
healthcare providers in different locations (Gagnon et al., 2016), reduces redundant tests
(Tierney et al., 1990), and lowers healthcare costs (Hillestad et al., 2005).
EHR allows continuity of care, enables reporting of a country's healthcare data, enhances
preventative care, aids in the establishment of patient portals, and aids in the promotion of
patient awareness programs in basic healthcare (Menachemi & Collum, 2011). Together, EHR
and Computerized Physician Order Entry (CPOE) can minimize medical errors by 55% (Bates,
1998). Moreover, when utilized in conjunction with a Clinical Decision Support (CDS) system,
it can minimize medical errors by 86%. (Fayaz-Bakhsh & Khezri, 2014). Thus, EHR can
improve the health of a nation's population and strengthen its healthcare system as a whole
(Menachemi & Collum, 2011).
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Archives of Business Research (ABR) Vol. 11, Issue 8, August-2023
Services for Science and Education – United Kingdom
ELECTRONIC HEALTH RECORDS ADOPTION IN INDIA AND AUSTRALIA
Developed nations (e.g., Australia) have made significant progress in developing a modern
digital healthcare system, and there is widespread EHR adoption in these nations. Australia's
established healthcare system places a great emphasis on digital health. Australia has
achieved great advancements in the implementation of EHRs. Strong infrastructure,
government support, and an emphasis on data security and privacy have all led to the
effective implementation of EHR in the Australian healthcare system (Hanna et al., 2016). The
Australian government created My Health Record, a centralized EHR system. The Australian
Digital Health Agency (ADHA) oversees the deployment of the My Health Record system,
which permits consumers and healthcare professionals to access and exchange health
information securely (Li et al., 2020). My Health Record employs strict security standards and
enables users to regulate access to their details, thereby alleviating privacy concerns. My
Health Record promises to improve coordination and communication between healthcare
professionals while empowering patients to participate more actively in managing their
health. Further, My Health Record promises to improve treatment coordination, eliminate test
duplication, and increase patient engagement (Vimalachandran et al., 2020). It can be stated
that the rate of EHR adoption in Australia has been relatively high, with a significant
proportion of the population possessing My Health Record (De Mesquita & Edwards, 2020).
My Health Record continues to evolve by incorporating new features and technology, leading
to a patient-centered and technologically advanced healthcare system.
Developing nations like India have lagged in adopting digital technologies for healthcare
management (Kumari & Singh, 2022). The healthcare system in India is broad and diverse,
serving nearly 1.4 billion people. EHRs adoption in India has been slowly increasing, but it has
been slower compared to some other developed countries due to various challenges,
including infrastructure limitations (Srivastava, 2016), resource crunch (Kumari & Singh,
2022; Hasan et al., 2022), data privacy concerns (Deshmukh, 2017; Singh, 2018; Mantri et al.,
2019), security issues (Singh, 2016; Singh, 2017; Pandey et al., 2017; Alshammari & Singh,
2018), interoperability challenges (Pai et al., 2021), a lack of standardized systems (Rinty et
al., 2021), low doctor-patient ratio (Bagcchi, 2015), over workload of medical staff (Nair et al.,
2022), and issues in transitioning from paper-based systems to digital platforms (Sharma &
Aggarwal, 2016). However, the Indian government has been promoting EHR adoption via
initiatives such as the Ayushman Bharat Digital Mission (ABDM) and the National Digital
Health Ecosystem (NDHM), which aims to create a digital health ecosystem in the country
(Jena et al., 2022). These initiatives endeavor to support universal health coverage in an
effective, affordable, comprehensive, judicious, and secure way by offering a vast array of
services, utilizing standardized digital systems, and guaranteeing the safety of sensitive
healthcare information (Jena et al., 2022). The National Health Policy has emphasized the
relevance of digital health and EHRs in India's healthcare system. It intends to encourage the
adoption of EHRs to enhance healthcare delivery, patient safety, and data management (NHP,
2017).
Prior research in developing and developed countries has mainly focused on government
policy (Jena et al., 2022; Liang et al., 2021), interoperability (Saripalle et al., 2019; Pai et al.,
2021), standardization (Kim et al., 2017; Ramirez et al., 2022), security (Enaizan et al., 2020;
Ochieng & Hosoi, 2005), technological infrastructure (Barbalho et al., 2022; Zhou et al., 2014),